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Zhang Z, Mocanu V, Deehan EC, Hotte N, Zhu Y, Wei S, Kao DH, Karmali S, Birch DW, Walter J, Madsen KL. Recipient microbiome-related features predicting metabolic improvement following fecal microbiota transplantation in adults with severe obesity and metabolic syndrome: a secondary analysis of a phase 2 clinical trial. Gut Microbes 2024; 16:2345134. [PMID: 38685731 PMCID: PMC11062372 DOI: 10.1080/19490976.2024.2345134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
Microbial-based therapeutics in clinical practice are of considerable interest, and a recent study demonstrated fecal microbial transplantation (FMT) followed by dietary fiber supplements improved glucose homeostasis. Previous evidence suggests that donor and recipient compatibility and FMT protocol are key determinants, but little is known about the involvement of specific recipient factors. Using data from our recent randomized placebo-control phase 2 clinical trial in adults with obesity and metabolic syndrome, we grouped participants that received FMT from one of 4 donors with either fiber supplement into HOMA-IR responders (n = 21) and HOMA-IR non-responders (n = 8). We further assessed plasma bile acids using targeted metabolomics and performed subgroup analyzes to evaluate the effects of recipient parameters and gastrointestinal factors on microbiota engraftment and homeostatic model assessment of insulin resistance (HOMA2-IR) response. The baseline fecal microbiota composition at genus level of recipients could predict the improvements in HOMA2-IR at week 6 (ROC-AUC = 0.70). Prevotella was identified as an important predictor, with responders having significantly lower relative abundance than non-responders (p = .02). In addition, recipients displayed a highly individualized degree of microbial engraftment from donors. Compared to the non-responders, the responders had significantly increased bacterial richness (Chao1) after FMT and a more consistent engraftment of donor-specific bacteria ASVs (amplicon sequence variants) such as Faecalibacillus intestinalis (ASV44), Roseburia spp. (ASV103), and Christensenellaceae spp. (ASV140) (p < .05). Microbiota engraftment was strongly associated with recipients' factors at baseline including initial gut microbial diversity, fiber and nutrient intakes, inflammatory markers, and bile acid derivative levels. This study identified that responders to FMT therapy had a higher engraftment rate in the transplantation of specific donor-specific microbes, which were strongly correlated with insulin sensitivity improvements. Further, the recipient baseline gut microbiota and related factors were identified as the determinants for responsiveness to FMT and fiber supplementation. The findings provide a basis for the development of precision microbial therapeutics for the treatment of metabolic syndrome.
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Affiliation(s)
- Zhengxiao Zhang
- College of Ocean Food and Biological Engineering, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian, China
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Valentin Mocanu
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Edward C. Deehan
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Food Science and Technology, University of Nebraska, Lincoln, NE, USA
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Yuanyuan Zhu
- College of Ocean Food and Biological Engineering, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian, China
| | - Shanshan Wei
- College of Ocean Food and Biological Engineering, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian, China
| | - Dina H. Kao
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Shahzeer Karmali
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Daniel W. Birch
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Jens Walter
- APC Microbiome Ireland, School of Microbiology and Department of Medicine, University College Cork, Cork, Ireland
| | - Karen L. Madsen
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Armstrong H, Rahbari M, Park H, Sharon D, Thiesen A, Hotte N, Sun N, Syed H, Abofayed H, Wang W, Madsen K, Wine E, Mason A. Mouse mammary tumor virus is implicated in severity of colitis and dysbiosis in the IL-10 -/- mouse model of inflammatory bowel disease. Microbiome 2023; 11:39. [PMID: 36869359 PMCID: PMC9983191 DOI: 10.1186/s40168-023-01483-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Following viral infection, genetically manipulated mice lacking immunoregulatory function may develop colitis and dysbiosis in a strain-specific fashion that serves as a model for inflammatory bowel disease (IBD). We found that one such model of spontaneous colitis, the interleukin (IL)-10 knockout (IL-10-/-) model derived from the SvEv mouse, had evidence of increased Mouse mammary tumor virus (MMTV) viral RNA expression compared to the SvEv wild type. MMTV is endemic in several mouse strains as an endogenously encoded Betaretrovirus that is passaged as an exogenous agent in breast milk. As MMTV requires a viral superantigen to replicate in the gut-associated lymphoid tissue prior to the development of systemic infection, we evaluated whether MMTV may contribute to the development of colitis in the IL-10-/- model. RESULTS Viral preparations extracted from IL-10-/- weanling stomachs revealed augmented MMTV load compared to the SvEv wild type. Illumina sequencing of the viral genome revealed that the two largest contigs shared 96.4-97.3% identity with the mtv-1 endogenous loci and the MMTV(HeJ) exogenous virus from the C3H mouse. The MMTV sag gene cloned from IL-10-/- spleen encoded the MTV-9 superantigen that preferentially activates T-cell receptor Vβ-12 subsets, which were expanded in the IL-10-/- versus the SvEv colon. Evidence of MMTV cellular immune responses to MMTV Gag peptides was observed in the IL-10-/- splenocytes with amplified interferon-γ production versus the SvEv wild type. To address the hypothesis that MMTV may contribute to colitis, we used HIV reverse transcriptase inhibitors, tenofovir and emtricitabine, and the HIV protease inhibitor, lopinavir boosted with ritonavir, for 12-week treatment versus placebo. The combination antiretroviral therapy with known activity against MMTV was associated with reduced colonic MMTV RNA and improved histological score in IL-10-/- mice, as well as diminished secretion of pro-inflammatory cytokines and modulation of the microbiome associated with colitis. CONCLUSIONS This study suggests that immunogenetically manipulated mice with deletion of IL-10 may have reduced capacity to contain MMTV infection in a mouse-strain-specific manner, and the antiviral inflammatory responses may contribute to the complexity of IBD with the development of colitis and dysbiosis. Video Abstract.
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Affiliation(s)
- Heather Armstrong
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Mandana Rahbari
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
| | | | - David Sharon
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Aducio Thiesen
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
| | - Naomi Hotte
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Ning Sun
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
- Li Ka Shing Institute for Virology, University of Alberta, Edmonton, Canada
| | - Hussain Syed
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
- Li Ka Shing Institute for Virology, University of Alberta, Edmonton, Canada
| | - Hiatem Abofayed
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
- Li Ka Shing Institute for Virology, University of Alberta, Edmonton, Canada
| | - Weiwei Wang
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Karen Madsen
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Eytan Wine
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Physiology, University of Alberta, Edmonton, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Andrew Mason
- Center of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
- Department of Medicine, University of Alberta, Edmonton, Canada
- Li Ka Shing Institute for Virology, University of Alberta, Edmonton, Canada
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2E1 Canada
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Selim Y, Di Lena É, Abu-Omar N, Baig Z, Verhoeff K, La J, Purich K, Albacete S, Valji R, Purich K, Safar A, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Daza J, Glass LT, Verhoeff K, Johnson G, Guidolin K, Glass LT, Balvardi S, Gawad N, McKechnie T, McKechnie T, Purich K, Henley J, Imbert E, Li C, Skinner S, Lenet T, Lenet T, Metz J, Ahn H(S, Do U, Rouhi A, Greenberg B, Muaddi H, Park L, Vogt K, Bradley N, Deng SX, Murphy P, Alhabboubi M, Lie J, Laplante S, Lie J, Drung J, Nixon T, Allard-Coutu A, Mansouri S, Lee A, Tweedy J, D’Elia MA, Hopkins B, Srivastava A, Alibhai K, Lee C, Moon J(J, How N, Spoyalo K, Lalande A, Baig Z, Schweitzer C, Keogh J, Huo B, Patel YS, Patel YS, Jogiat U, McGuire AL, Jogiat U, Lee Y, Barber E, Akhtar-Danesh GG, Bondzi-Simpson A, Bowker R, Ahmadi N, Abdul SA, Patel P, Harrison L, Shi G, Shi G, Alaichi JA, Kidane B, Qu LC, Alaichi J, Mackay E, Lee J, Purich K, Castelo M, Caycedo-Marulanda A, Caycedo-Marulanda A, Brennan K, Brennan K, Brennan K, Garfinkle R, Sharma S, Candy S, Patel S, LeGal G, Spadafora S, Maclellan S, Trottier D, Jonker D, Asmis T, Mallick R, Ramsay T, Carrier M, McKechnie T, Shojaei D, Motamedi A, Ghuman A, Karimuddin A, Raval M, Brown C, Shojaei D, Wang H, Buie D, Wang H, McKechnie T, Buie D, Al Busaidi N, Rajabiyazdi F, Demian M, Boutros M, Farooq A, Brown C, Phang T, Ghuman A, Karimuddin A, McKechnie T, Raval M, Udwadia F, Marinescu D, Alqahtani M, Pang A, Vasilevsky CA, Boutros M, Oviedo SC, McFadden N, Spence R, Lee L, Hirsch G, Neumann K, Neumann K, Spence R, Johnson G, Singh H, Helewa R, Yilbas A, Netto FS, Katz J, Robitaille S, Sharma B, Khan U, Selzner M, Mocanu V, Dang J, Wilson H, Switzer N, Birch D, Karmali S, Mocanu V, Robitaille S, Jogiat U, Forbes H, Switzer N, Birch D, Karmali S, Verhoeff K, Mocanu V, Kung J, Purich K, Switzer N, Sadri H, Birch D, Karmali S, Tassé N, Tchernof A, Nadeau M, Dawe P, Beckett A, Biertho L, Lin A, Verhoeff K, Selznick S, Mocanu V, Kung JY, Birch DW, Karmali S, Switzer NJ, Fowler-Woods M, Fowler-Woods A, Shingoose G, Hatala A, Daeninck F, Wiseman V, Vergis A, Hardy K, Clouston K, Debru E, Sun W, Dang J, Switzer N, Birch D, Karmali S, De Gara C, Wiseman V, Halasz J, Dang J, Switzer N, Kanji A, Birch D, Modi R, Karmali S, Gu J, Jarrar A, Kolozsvari N, Wiseman V, Samarasinghe Y, Chen L, Hapugall A, Javidan A, McKechnie T, Doumouras A, Hong D, Laplante S, Stogryn S, Maeda A, Brennan K, Jackson T, Okrainec A, Birch D, Karmali S, Kanji A, Switzer N, Balas M, Gee D, Hutter M, Meireles O, Baker L, Jung J, Vergis A, Hardy K, Boudreau V, Hong D, Anvari M, Iranmanesh P, Barlow K, Cookson T, Bolis R, Ichhpuniani S, Shanthanna H, Shiroky J, Deghan S, Zevin B, Cloutier Z, Cookson T, Barlow K, Boudreau V, Anvari M, Brodie J, Johnson G, O’Brien E, Tedman-Aucoin K, Lawlor D, Murphy R, Twells L, Pace D, Ellsmere J, Evans B, Zhang T, Deehan E, Zhang L, Kao D, Hotte N, Birch D, Karmali S, Samarasinghe K, Walter J, Madsen K, Williams E, Kong W, Fundytus A, Holden J, Booth C, Patel S, Caycedo-Marulanda A, Chung W, Nanji S, Merchant S, Hansen B, Paszat L, Baxter N, Scheer A, Moon J(J, Ghezeljeh TN, Lapointe-Gagner M, Nguyen-Powanda P, Elhaj H, Rajabiyazdi F, Lee L, Feldman LS, Fiore J, Sutradhar R, Haas B, Moon J(J, Guttman M, Eskander A, Coburn N, Chesney T, Tillman B, Zuk V, Mahar A, Hsu A, Chan W, Hallet J, Moon J(J, Guidolin K, Servidio-Italiano F, Quereshy F, Sapisochin G, Prisman E, Mitmaker E, Walker R, Wu J, Nguyen A, Wiseman S, Moon J(J, Hong D, Gupta M, Pasternak J, Vergara-Fernandez O, Brar A, Conner J, Kirsch R, Brar M, Kennedy E, Govindarajan A, Paradis T, Gryfe R, MacRae H, Cohen Z, McLeod R, Swallow C, Ghasemi F, Delisle M, Stacey D, Abou-Khalil J, Balaa F, Bayat Z, Bertens K, Dingley B, Martel G, McAlpine K, Nessim C, Tadros S, Carrier M, Auer R, Lim D, Eskander A, Patel S, Coburn N, Sutradhar R, Chan W, Hallet J, Pickard F, Mathieson A, Hogan M, Seal M, Acidi B, Johnston W, Maalouf MF, Callegaro D, Brar S, Gladdy R, Chung P, Catton C, Khalili K, Honore C, Swallow C, Fu N, Kazazian K, Wachtel A, Pacholczyk K, Ng D, Swett-Cosentino J, Savage P, Shibahara Y, Kalimuthu S, Espin-Garcia O, Conner J, Yeung J, Darling G, Baronas V, Swallow C, Mercier F, Barabash V, Law C, Coburn N, Singh S, Myrehaug S, Chan W, Hallet J, Auer RC, Wiseman V, Muhn N, Heller B, Lovrics P, Ng D, Koerber D, Al-Sukhni E, Cyr D, Kazazian K, Swallow C, Apte S, Lie J, Nessim C, Ban J, Chen L, McKevitt E, Warburton R, Pao JS, Dingee C, Kuusk U, Bazzarelli A, Hong NL, Hajjar R, Gagliardi A, Nyhof B, Marfil-Garza B, Sandha G, Cooper D, Dajani K, Bigam D, Anderson B, Kin T, Lam A, Ehlebracht A, O’Gorman D, Senior P, Ricordi C, Shapiro AJ, Moser M, Lam H, Flemming J, Jalink D, Nanji S, Bennett S, Caminsky N, Zhang B, Tywonek K, Meyers B, Serrano P, Lenet T, Shorr R, Abou-Khalil J, Bertens K, Balaa F, Martel G, Caminsky N, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Williams P, Claasen M, Ivanics T, Gilbert R, Englesakis M, Gallinger S, Hansen B, Sapisochin G, Ivanics T, Claasen M, Gallinger S, Hansen B, Sapisochin G, Lenet T, Morin G, Abou-Khalil J, Balaa F, Martel G, Brind’Amour A, Bertens K, Balaa F, Bertens K, Martel G, Abou-Khalil J, Collin Y, Auer RC, Ivanics T, Toso C, Adam R, Ijzermans J, Sapisochin G, Polak W, Léveillé M, Lawson C, Collin Y, Tai LH, Phang T, Greene B, Jayaraman S, Tsang M, Al-Arnawoot A, Rajendran L, Lamb T, Turner A, Reid M, Rekman J, Mimeault R, Hopkins J, Abou-Khalil J, Bertens K, Martel G, Balaa F, Zhang C, Lemke M, Glinka J, Leslie K, Skaro A, Tang E, Hopkins J, Greene B, Tsang M, Jayaraman S, Bubis L, Jayaraman S, Tsang ME, Ganescu O, Vanounou T, Pelletier JS, Greene B, Levin Y, Tsang M, Jayaraman S, Ganescu O, Pelletier JS, Vanounou T, Choi WJ, Muaddi H, Ivanics T, Classen MP, Sapisochin G, Alam A, Caminsky N, Mansouri S, Lagace P, Lagace P, El-Kefraoui C, Mainprize M, Melland-Smith M, Verhoeff K, Verhoeff K, Nasser K, Mailloux O, Purich K, Whyte M, Li T, Ahmad MS, Sun W, Ahn H(S, Lee Y, Roach E, Chow A, Trac J, He W, Ramji K, Kouzmina E, Koziak C, Hossain I, Mocanu V, Hanna N, Castelo M, Pook M, Zuckerman J, Choi WJ, Watanabe A, Saravana-Bawan B, Cyr D, Brackstone M, Ivankovic V, Nair AG, Hirpara D, Stockley C, Ng D, Luu S, Meloche-Dumas L, D’Elia MA, Eom A, Tang K, Khan S, Schmitz E, Chen KT, Newman-Bremang J, Verhoeff K, Jette N, Mir Z, Griffiths C, Rajendran L, Zuckerman J, Choi WJ, Choi WJ, Gilbert R, Lenet T, Amhis N, Claasen M, Mansouri S, Workewych A, Lee A, Waugh E, Zhu A, Nabavian H, Roldan J, Lagrotteria A, Roldan J, Rajendran L, Safa N, Rahman S, Kaneva P, Feldman L, Baig Z, Ginther N, Gill D, Sarwar Z, Verdiales C, Moser M, Mocanu V, Fang B, Dang J, Sun W, Switzer N, Birch D, Karmali S, Alqaydi A, Wei X, Digby G, Brogly S, Merchant S, Verhoeff K, Miles A, Kung JY, Shapiro AJ, Bigam DL, Matkin A, Dumestre D, Peiris L, Turner S, Verhoeff K, Mador B, McLennan S, Jastaniah A, Owattanapanich N, Grigorian A, Lam L, Nahmias J, Inaba K, Liasidis P, Inaba K, Demetriades D, Benjamin ER, Cowan S, Owattanapanich N, Wong MD, Inaba K, Demetriades D, Owattanapanich N, Emigh B, Karavites L, Clark DH, Lam L, Inaba K, Benjamin ER, Owattanapanich N, Inaba K, Demetriades D, Anderson GA, Owattanapanich N, Cheng V, Lam L, Inaba K, Myers L, Cuthbertson B, Myles P, Shulman M, Wijeysundera D, Murphy PB, Allen L, Minkhorst K, Bowker D, Tang ES, Leslie K, Hawel JE, Ma O, Purich K, Skinner S, Dhaliwal R, Strickland M, Park J, Vergis A, Gillman L, Rivard J, Lin J, Zorigtbaatar A, Nadeem M, Ibrahim T, Neilson Z, Kim KY(P, Rajendran L, Chadi S, Quereshy F, Davidson M, Friedrich E, Champion C, Semsar-Kazerooni K, Kaneva P, Mueller C, Vassiliou M, Al Mahroos M, Fiore J, Schwartzman K, Feldman L, Purich K, Verhoeff K, Anderson B, Daniel R, Kruse C, Levin M, Lee Y, Doumouras A, Hong D, Eskicioglu C, Povolo C, Lee J, Lee Y, Park L, Doumouras A, Hong D, Bhandari M, Eskicioglu C, Lee E, Verhoeff K, Sydora D, Turner S, Strickland M, Boone D, Roberts S, McGrouther D, Manuel P, Dykstra M, Wang H, Snelgrove R, Verhoeff K, Purich K, Perry T, Strickland M, Dhaliwal R, Skanes S, Tropiano J, McIsaac D, Tinmouth A, Hallet J, Nicholls S, Fergusson D, Martel G, Tropiano J, Skanes S, Ivankovic V, McIsaac D, Tinmouth A, Patey A, Fergusson D, Martel G, Naqvi R, Noppens R, Hawel J, Elnahas A, Schlachta C, Alkhamesi N, Lenet T, Gilbert R, Mallick R, Shaw J, McIsaac D, Martel G, Pook M, Najafi T, Rajabiyazdi F, El-Kefraoui C, Balvardi S, Barone N, Elhaj H, Nguyen-Powanda P, Lee L, Baldini G, Feldman L, Fiore J, Purich K, Jogiat U, Mapiour D, Kim M, Nadler A, Stukel T, De Mestral C, Nathens A, Pautler S, Shayegan B, Hanna W, Schlachta C, Breau R, Hopkins L, Jackson T, Karanicolas P, Griffiths C, Ali S, Archer V, Cloutier Z, Choi D, McKechnie T, Serrano P, McClure JA, Jones P, Mrkobrada M, Flier S, Welk B, Dubois L, Khwaja K, Allen L, Tung L, Hameed M, Spoyalo K, Lampron J, Garcia-Ochoa C, Jastaniah A, Engels P, Talwar G, Cloutier Z, Minor S, Moffat B, Parry N, Vogt K, Ebeye T, Sharma BT, Samman A, Zulfiqar A, Purzner RH, Greene B, Tsang M, Jayaraman S, Allen L, Ball CG, Hameed M, Engels P, Nenshi R, Widder S, Minor S, Parry N, Bradley N, Moffat B, Vogt K, Liberman S, Wong E, Chughtai T, Turner J, Wiseman S, Li J, Mak N, Namazi B, Kiani P, Hashimoto D, Alseidi A, Pasten M, Brunt LM, Gill S, Davis B, Bloom M, Pernar L, Okrainec A, Madani A, Hamilton T, Nabata K, Zhang JW, Zhao D, Dawe P, Hameed M, Allen L, Leslie K, Drung J, Purich K, Verhoeff K, Skinner S, Dhaliwal R, Strickland M, Heller B, Wright V, Cho W, Wong M, Singh K, Comeau É, Collin Y, Oviedo SC, Rajendran L, Lamb T, Reid M, Turner A, Bertens K, Rekman J, Balaa F, Neumann K, Porter G, Teo I, Forse CL, Musselman R, Grozman L, Alshawan N, Fraser S, Bergman S, Pelletier JS, Vanounou T, Wong EG, Nolan B, Qiao L, Jung J, Raîche I, McDonald H, Gawad N, Cheifetz R, Hawley P, Rehany Z, Bakhshi M, Razek T, Grushka J, Boulanger N, Watt L, Vivier A, Clark G, Fata P, Deckelbaum D, Khwaja K, Jastaniah A, Wong E, Ren K, Qiu Y, Hamann K, Lalande A, MacNeill A, Park J, Alexis S, Spoyalo K, Patterson K, Gadhari N, Zhao J, MacNeill A, Ahmed R, Farooq A, Karimuddin A, Wiseman S, Chhor A, Begum H, Akhtar-Danesh N, Finley C, Manos D, Xu Z, Matheson K, Chun S, Fris J, Wallace A, French D, Baste JM, Shargall Y, Waddell TK, Yasufuku K, Machuca TN, Xie F, Thabane L, Hanna WC, Beauchamp MK, Wald J, Mbuagbaw L, Key BL, Green SM, Hanna WC, Behzadi A, Donahoe L, Nasralla A, Poon J, Safieddine N, Seyednejad N, Tavakoli I, Turner S, Sharma S, Hilzenrat RA, McConechy M, Frank I, Hughsman C, Yip S, Choi JJ, Yee J, Sasewich H, Turner S, Baracos V, Eurich D, Filafilo H, Bedard E, Samarasinghe Y, Patel J, Khondker A, McKechnie T, Samarasinghe N, Finley C, Hanna W, Shargall Y, Agzarian J, Whidden M, Aguirre F, Graham A, Chhor A, Begum H, Ewusie J, Mbuagbaw L, Yaron S, Keshishi M, Ademe Y, Tizazu A, Rose M, Uddin S, Ko M, Ddamba J, French D, Wallace A, Safieddine N, Gazala S, Simone C, Wright F, Finley C, Villeneuve PJ, Gilbert S, Sundaresan S, Seely AJ, Maziak DE, Manos D, Wallace A, Plourde M, Turner D, Ringash J, Manuel D, Kidane B, Gupta V, Decker K, Davis L, Darling G, Compton C, Coburn N, Boyes R, Pugliese M, Mahar A, Hsu A, Kokavec A, Ho E, Waterman R, Wang E, Harnden K, Malthaner R, Nayak R, Qiabi M, Malthaner R, Nayak R, Qiabi M, Patel Y, Farrokhyar F, Simunovic M, Hanna WC, Gowing S, Liu R, Srinathan S, Tan L, Malthaner R, Malik P, Patel Y, Hanna W, Fahim U, Hafizi A, Ashrafi AS, McKechnie T, Amin N, Doumouras A, Hong D, Eskicioglu C, Streu C, Wong C, Schiller D, Sue-Chue-Lam C, Paszat L, Scheer A, Hansen B, Kishibe T, Baxter N, Neary E, Ibrahim T, Verschoor C, Patel S, Merchant S, Chadi S, Romagnolo L, Verschoor C, Brown C, Karimuddin A, Raval M, Phang T, Vikis E, Melich G, Patel S, Patel S, Caycedo-Marulanda A, Merchant S, Booth C, Kong W, McClintock C, Bankhead C, Heneghan C, Patel S, McClintock C, Merchant S, Caycedo-Marulanda A, Booth C, Bankhead C, Heneghan C, Zhang L, Flemming J, Djerboua M, Nanji S, Caycedo-Marulanda A, Merchant S, Patel S, Demian M, Sabboobeh S, Moon J, Hulme-Moir M, Liberman AS, Feinberg S, Hayden DM, Chadi SA, Demyttenaere S, Samuel L, Hotakorzian N, Quintin L, Morin N, Ghitulescu G, Faria J, Vasilevsky CA, Boutros M, Mckechnie T, Khamar J, Ichhpuniani S, Eskicioglu C, Patel S, Merchant S, Caycedo-Marulanda A, Bankhead C, Heneghan C, Govind S, Lee J, Lee Y, Hong D, Eskicioglu C, Lu J, Khamar J, Lee Y, Amin N, Hong D, Eskicioglu C, Cardenas L, Schep D, Doumouras A, Hong D, Wong R, Levine O, Eskicioglu C, Mueller C, Stein B, Charlebois P, Liberman S, Fried G, Feldman L, Wang A, Liberman S, Charlebois P, Stein B, Fiore JF, Feldman L, Lee L, Wang A, Liberman S, Charlebois P, Stein B, Fiore JF, Feldman L, Lee L, Barkun A, Levy J, Bogdan R, Hawel J, Elnahas A, Alkhamesi NA, Schlachta CM, Caycedo-Marulanda A, Iaboni N, Hurlbut D, Kaufmann M, Ren KYM, Jamzad A, Mousavi P, 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Closed-incision negative-pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients21. Robotic Appleby procedure for recurrent pancreatic cancer22. The influence of viral hepatitis status on posthepatectomy complications in patients with hepatocellular carcinoma: a NSQIP analysis. Can J Surg 2022. [DOI: 10.1503/cjs.014322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Peerani F, Watt M, Ismond KP, Whitlock R, Ambrosio L, Hotte N, Mitchell N, Bailey RJ, Kroeker K, Dieleman LA, Siffledeen J, Lim A, Wong K, Halloran BP, Baumgart DC, Taylor L, Raman M, Madsen KL, Tandon P. A randomized controlled trial of a multicomponent online stress reduction intervention in inflammatory bowel disease. Therap Adv Gastroenterol 2022; 15:17562848221127238. [PMID: 36187365 PMCID: PMC9520184 DOI: 10.1177/17562848221127238] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/30/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Psychological stress negatively impacts inflammatory bowel disease (IBD) outcomes. Patients have prioritized access to online interventions; yet, the data on these have been limited by mixed in-person/online interventions, low adherence, and non-randomized controlled trial (RCT) design. OBJECTIVES We assessed the efficacy of and adherence to a 12-week online multicomponent stress reduction intervention in IBD. DESIGN This is a RCT. METHODS Adult participants on stable IBD medical therapy with elevated stress levels from four centers were randomized to intervention or control groups. Intervention participants received a 12-week online program including a weekly yoga, breathwork and meditation video (target 2-3 times/week), a weekly cognitive behavioral therapy/positive psychology informed video activity, and weekly 10-min check-ins by a study team member. Control participants received weekly motivational messages by email. All patients received standard of care IBD therapy. The primary outcome was Cohen's Perceived Stress Scale (PSS). Secondary outcomes evaluated mental health, resilience, health-related quality of life (HRQoL), symptom indices, acceptability, adherence, and inflammatory biomarkers. Analysis of covariance was used to determine between-group differences. RESULTS Of 150 screened patients, 101 were randomized to the intervention (n = 49) and control (n = 52) groups (mean age: 42.5 ± 14.1 years; M:F 1:3, 48% with ulcerative colitis and 52% with Crohn's disease). The between-group PSS improved by 22.4% (95% confidence interval, 10.5-34.3, p < 0.001). Significant improvements were seen in mental health, resilience, and HRQoL measures, with a median satisfaction score of 89/100 at the end of the 12 weeks. In the 44/49 patients who completed the intervention, 91% achieved program adherence targets. CONCLUSION This 12-week online intervention improved perceived stress, mental health, and HRQoL, but did not impact IBD symptom indices or inflammatory biomarkers. The program was readily adopted and adhered to by participants with high retention rates. After iterative refinement based on participant feedback, future studies will evaluate the impact of a longer/more intense intervention on disease course. REGISTRATION ClinicalTrials.gov Identifier NCT03831750. PLAIN LANGUAGE SUMMARY An online stress reduction intervention in inflammatory bowel disease patients improves stress, mental health, and quality of life People with inflammatory bowel disease (IBD) have high levels of stress, anxiety, and depression. Although IBD patients have expressed the need for online mental wellness interventions, the existing data to support these interventions in IBD are limited. In this trial, 101 IBD patients had the chance to participate in a 12-week online stress reduction intervention. In those patients randomly selected to participate in the online intervention, each week they received the following: a 20- to 30-min yoga, breathwork, and meditation video that they were asked to do 2-3 times a week, a 10- to 20-min mental wellness activity they were asked to do once during the week, and a 10-min telephone check-in with a study team member. Participants who were not selected to use the online intervention received a weekly motivational message by email. In all, 90 of the 101 participants (89%) completed the study with the mean age of participants being 43 years and the majority being females (75%). Ninety-one percent of participants who completed the intervention met the program target of doing the yoga, breathwork, and meditation video at least 2 times per week. Significant improvements were seen in perceived stress (by 22.4%), depression (by 29.5%), anxiety (by 23.7%), resilience (by 10.6%), and quality of life (by 8.9%). No changes were seen in IBD severity or in blood markers of inflammation. In conclusion, this study demonstrates evidence that a 12-week online stress reduction intervention had low dropout rates, high adherence and beneficial effects on stress, mental health, and quality of life measures. Continued feedback will be sought from study participants and our IBD patient partners to refine the intervention and assess the impact in future studies of patients with active IBD, as well as the impact of a longer/more intense intervention.
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Affiliation(s)
- Farhad Peerani
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Makayla Watt
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kathleen P Ismond
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Reid Whitlock
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Lindsy Ambrosio
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Naomi Hotte
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Nicholas Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Robert J Bailey
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Karen Kroeker
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Levinus A Dieleman
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jesse Siffledeen
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Allen Lim
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Karen Wong
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Brendan P Halloran
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Daniel C Baumgart
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lorian Taylor
- Division of Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - Maitreyi Raman
- Division of Gastroenterology, University of Calgary, Calgary, AB, Canada
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5
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Wu RY, Xiao K, Hotte N, Tandon P, Elloumi Y, Ambrosio L, Dunsmore G, Elahi S, Kroeker KI, Dieleman LA, Madsen KL, Huang V. Elevated IL-6 and IL-22 in Early Pregnancy Are Associated with Worse Disease Course in Women with Inflammatory Bowel Disease. Int J Mol Sci 2022; 23:ijms231810281. [PMID: 36142193 PMCID: PMC9499187 DOI: 10.3390/ijms231810281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 01/08/2023] Open
Abstract
Inflammatory bowel diseases (IBD), including Ulcerative Colitis (UC) and Crohn’s disease (CD), are inflammatory conditions of the intestinal tract that affect women in their reproductive years. Pregnancy affects Th1- and Th2-cytokines, but how these changes occur during pregnancy in IBD is unclear. We performed a longitudinal profiling of serum cytokines in a cohort of 11 healthy pregnant women and 76 pregnant women with IBD from the first trimester of pregnancy to the first 12 months post-partum. Participants were monitored for biochemical disease activity (C-reactive protein [CRP] and fecal calprotectin [FCP]) and clinical activities. Maternal cytokines were measured using ELISA. We identified changes in Th1 and Th17 cytokines throughout pregnancy in healthy pregnant women. During pregnancy, maternal serum cytokine expressions were influenced by IBD, disease activity, and medications. Active UC was associated with an elevation in IL-21, whereas active CD was associated with elevated IFN-γ, IL-6, and IL-21. Interestingly, T1 serum cytokine levels of IL-22 (>0.624 pg/mL) and IL-6 (>0.648 pg/mL) were associated with worse IBD disease activity throughout pregnancy in women with UC and CD, respectively. This shows serum cytokines in pregnancy differ by IBD, disease activity, and medications. We show for the first time that T1 IL-22 and IL-6 correlate with IBD disease course throughout pregnancy.
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Affiliation(s)
- Richard Y. Wu
- Department of Medicine, University of Toronto, Toronto, ON M5T 2S8, Canada
- Division of Gastroenterology and Hepatology, Mount Sinai Hospital, Toronto, ON M5T 2S8, Canada
| | - Karren Xiao
- Division of Gastroenterology and Hepatology, Mount Sinai Hospital, Toronto, ON M5T 2S8, Canada
| | - Naomi Hotte
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, Mount Sinai Hospital, Toronto, ON M5T 2S8, Canada
| | - Yesmine Elloumi
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Lindsy Ambrosio
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Garett Dunsmore
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Shokrollah Elahi
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Department of Oncology, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Karen I. Kroeker
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Levinus A. Dieleman
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Karen L. Madsen
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vivian Huang
- Division of Gastroenterology and Hepatology, Mount Sinai Hospital, Toronto, ON M5T 2S8, Canada
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Correspondence: ; Tel.: +1-416-586-4800 (ext. 2475)
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6
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Dang JT, Mocanu V, Park H, Laffin M, Hotte N, Karmali S, Birch DW, Madsen KL. Roux-en-Y gastric bypass and sleeve gastrectomy induce substantial and persistent changes in microbial communities and metabolic pathways. Gut Microbes 2022; 14:2050636. [PMID: 35316158 PMCID: PMC8942407 DOI: 10.1080/19490976.2022.2050636] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Bariatric surgery induces significant microbial and metabolomic changes, however, links between microbial and metabolic pathways have not been fully elucidated. The objective of this study was to conduct a comprehensive investigation of the microbial, metabolomic, and inflammatory changes that occur following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). A prospective clinical trial was conducted with participants undergoing RYGB, SG, and non-operative controls (CTRL). Clinical parameters, blood samples, and fecal samples were collected pre-intervention and at 3 and 9 months. A multi-omics approach was used to perform integrated microbial-metabolomic analysis to identify functional pathways in which weight loss and metabolic changes occur after surgery. RYGB led to profound microbial changes over time that included reductions in alpha-diversity, increased Proteobacteria and Verrucomicrobiota, decreased Firmicutes, and numerous changes at the genera level. These changes were associated with a reduction in inflammation and significant weight loss. A reduction in Romboutsia genera correlated strongly with weight loss and integrated microbial-metabolomic analysis revealed the importance of Romboutsia. Its obliteration correlated with improved weight loss and insulin resistance, possibly through decreases in glycerophospholipids. In contrast, SG was associated with no changes in alpha-diversity, and only a small number of changes in microbial genera. A cluster of Firmicutes genera including Butyriciccocus, Eubacterium ventriosum, and Monoglobus was decreased, which correlated with decreased weight, insulin resistance, and systemic inflammation. This work represents comprehensive analyses of microbial-metabolomic changes that occur following bariatric surgery and identifies several pathways that are associated with beneficial metabolic effects of surgery.
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Affiliation(s)
- Jerry T. Dang
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada,CONTACT Jerry T. Dang Division of General Surgery, Department of Surgery, University of Alberta, University of Alberta Hospital, 8440 112 Street NW, Edmonton, AB, CanadaT6G 2B7
| | - Valentin Mocanu
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Heekuk Park
- Department of Medicine, Columbia University, New York, New York, USA
| | - Michael Laffin
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Shahzeer Karmali
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Daniel W. Birch
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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7
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Wu RY, Tandon P, Ambrosio L, Dunsmore G, Wang G, Hotte N, Dieleman LA, Elahi S, Madsen K, Huang V. A175 DISEASE ACTIVITY IN FIRST TRIMESTER IS ASSOCIATED WITH REDUCED GROWTH IN INFANTS BORN TO WOMEN WITH INFLAMMATORY BOWEL DISEASE. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859139 DOI: 10.1093/jcag/gwab049.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory bowel diseases (IBD) that affect a significant portion of women in childbearing years. It is known that disease activity in early pregnancy negatively impacts obstetrical and perinatal outcomes, but the impact on infant growth is largely unknown. Aims The objective of this study was to compare the growth of infants born to women with active IBD during pregnancy versus those born to women with IBD in remission during pregnancy. Methods We conducted a prospective cohort study in a Canadian tertiary centre comprised of 98 pregnant women with IBD (63 with UC and 35 with CD) and 13 healthy pregnant women. We collected maternal demographic at trimester 1 and assessed disease activity at each trimester using clinical disease scores and fecal calprotectin. We then collected perinatal outcomes at delivery and followed the infants’ growth and feeding habits up to 12 months of age. Results A total of 103 mother-infant pairs were included in the study, of which 88 infants were born to women with IBD, and 15 born to women with active disease at trimester 1. Active disease at trimester 1 was associated with more adverse obstetrical outcomes, reduced 1-minute and 5-minute APGAR scores and more frequent NICU admissions. Infants born to women with active trimester 1 disease had reduced weight-for-age and length-for-age Z scores up to 6 months of age, in the absence of difference in feeding patterns. In addition, women with active disease at trimester 1 had increased expression of IL-8 and IFN-γ compared to those with trimester 1 remission. Conclusions Active IBD during first trimester is correlated with decreased infant weight and height up to 6 months of age, suggesting that strict disease control during first trimester, or even preconception, is essential for optimizing infant growth and perinatal outcomes. ![]()
Funding Agencies None
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Affiliation(s)
- R Y Wu
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - P Tandon
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - L Ambrosio
- University of Alberta, Edmonton, AB, Canada
| | - G Dunsmore
- University of Alberta, Edmonton, AB, Canada
| | - G Wang
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - N Hotte
- University of Alberta, Edmonton, AB, Canada
| | | | - S Elahi
- University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
| | - V Huang
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
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8
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Jovel J, Nimaga A, Jordan T, O’Keefe S, Patterson J, Thiesen A, Hotte N, Bording-Jorgensen M, Subedi S, Hamilton J, Carpenter EJ, Lauga B, Elahi S, Madsen KL, Wong GKS, Mason AL. Metagenomics Versus Metatranscriptomics of the Murine Gut Microbiome for Assessing Microbial Metabolism During Inflammation. Front Microbiol 2022; 13:829378. [PMID: 35185850 PMCID: PMC8851394 DOI: 10.3389/fmicb.2022.829378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/11/2022] [Indexed: 01/26/2023] Open
Abstract
Shotgun metagenomics studies have improved our understanding of microbial population dynamics and have revealed significant contributions of microbes to gut homeostasis. They also allow in silico inference of the metagenome. While they link the microbiome with metabolic abnormalities associated with disease phenotypes, they do not capture microbial gene expression patterns that occur in response to the multitude of stimuli that constantly ambush the gut environment. Metatranscriptomics closes that gap, but its implementation is more expensive and tedious. We assessed the metabolic perturbations associated with gut inflammation using shotgun metagenomics and metatranscriptomics. Shotgun metagenomics detected changes in abundance of bacterial taxa known to be SCFA producers, which favors gut homeostasis. Bacteria in the phylum Firmicutes were found at decreased abundance, while those in phyla Bacteroidetes and Proteobacteria were found at increased abundance. Surprisingly, inferring the coding capacity of the microbiome from shotgun metagenomics data did not result in any statistically significant difference, suggesting functional redundancy in the microbiome or poor resolution of shotgun metagenomics data to profile bacterial pathways, especially when sequencing is not very deep. Obviously, the ability of metatranscriptomics libraries to detect transcripts expressed at basal (or simply low) levels is also dependent on sequencing depth. Nevertheless, metatranscriptomics informed about contrasting roles of bacteria during inflammation. Functions involved in nutrient transport, immune suppression and regulation of tissue damage were dramatically upregulated, perhaps contributed by homeostasis-promoting bacteria. Functions ostensibly increasing bacteria pathogenesis were also found upregulated, perhaps as a consequence of increased abundance of Proteobacteria. Bacterial protein synthesis appeared downregulated. In summary, shotgun metagenomics was useful to profile bacterial population composition and taxa relative abundance, but did not inform about differential gene content associated with inflammation. Metatranscriptomics was more robust for capturing bacterial metabolism in real time. Although both approaches are complementary, it is often not possible to apply them in parallel. We hope our data will help researchers to decide which approach is more appropriate for the study of different aspects of the microbiome.
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Affiliation(s)
- Juan Jovel
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Office of Research, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Juan Jovel,
| | - Aissata Nimaga
- Universite de Pau et des Pays de l’Adour, E2S UPPA, CNRS, IPREM, Pau, France
| | - Tracy Jordan
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sandra O’Keefe
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jordan Patterson
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Aducio Thiesen
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Sudip Subedi
- Office of Research, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jessica Hamilton
- Office of Research, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eric J. Carpenter
- Department of Biological Sciences, University of Alberta, Edmonton, AB, Canada
| | - Béatrice Lauga
- Universite de Pau et des Pays de l’Adour, E2S UPPA, CNRS, IPREM, Pau, France
| | - Shokrollah Elahi
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Gane Ka-Shu Wong
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Biological Sciences, University of Alberta, Edmonton, AB, Canada
- BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China
| | - Andrew L. Mason
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Andrew L. Mason,
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9
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Dang JT, Mocanu V, Park H, Laffin M, Tran C, Hotte N, Karmali S, Birch DW, Madsen K. Ileal microbial shifts after Roux-en-Y gastric bypass orchestrate changes in glucose metabolism through modulation of bile acids and L-cell adaptation. Sci Rep 2021; 11:23813. [PMID: 34893681 PMCID: PMC8664817 DOI: 10.1038/s41598-021-03396-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/29/2021] [Indexed: 01/03/2023] Open
Abstract
Roux-en-Y gastric bypass (RYGB)-induced glycemic improvement is associated with increases in glucagon-like-peptide-1 (GLP-1) secreted from ileal L-cells. We analyzed changes in ileal bile acids and ileal microbial composition in diet-induced-obesity rats after RYGB or sham surgery to elucidate the early and late effects on L-cells and glucose homeostasis. In early cohorts, there were no significant changes in L-cell density, GLP-1 or glucose tolerance. In late cohorts, RYGB demonstrated less weight regain, improved glucose tolerance, increased L-cell density, and increased villi height. No difference in the expression of GLP-1 genes was observed. There were lower concentrations of ileal bile acids in the late RYGB cohort. Microbial analysis demonstrated decreased alpha diversity in early RYGB cohorts which normalized in the late group. The early RYGB cohorts had higher abundances of Escherichia-Shigella but lower abundances of Lactobacillus, Adlercreutzia, and Proteus while the late cohorts demonstrated higher abundances of Escherichia-Shigella and lower abundances of Lactobacillus. Shifts in Lactobacillus and Escherichia-Shigella correlated with decreases in multiple conjugated bile acids. In conclusion, RYGB caused a late and substantial increase in L-cell quantity with associated changes in bile acids which correlated to shifts in Escherichia-Shigella and Lactobacillus. This proliferation of L-cells contributed to improved glucose homeostasis.
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Affiliation(s)
- Jerry T Dang
- Division of General Surgery, Department of Surgery, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada.
| | - Valentin Mocanu
- Division of General Surgery, Department of Surgery, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
| | - Heekuk Park
- Department of Medicine, Columbia University, New York City, NY, USA
| | - Michael Laffin
- Division of General Surgery, Department of Surgery, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
| | - Caroline Tran
- Department of Biological Sciences, University of Alberta, Edmonton, AB, Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Shahzeer Karmali
- Division of General Surgery, Department of Surgery, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
| | - Daniel W Birch
- Division of General Surgery, Department of Surgery, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
| | - Karen Madsen
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
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10
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Mocanu V, Zhang Z, Deehan EC, Kao DH, Hotte N, Karmali S, Birch DW, Samarasinghe KK, Walter J, Madsen KL. Fecal microbial transplantation and fiber supplementation in patients with severe obesity and metabolic syndrome: a randomized double-blind, placebo-controlled phase 2 trial. Nat Med 2021; 27:1272-1279. [PMID: 34226737 DOI: 10.1038/s41591-021-01399-2] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/18/2021] [Indexed: 02/07/2023]
Abstract
Fecal microbial transplantation (FMT) from lean donors to patients with obesity has been associated with metabolic benefits, yet results so far have been inconsistent. In this study, we tested the application of daily fiber supplementation as an adjunct to FMT therapy to modulate cardiometabolic outcomes. We performed a double-blind randomized trial in patients with severe obesity and metabolic syndrome receiving oral FMT, to test high-fermentable (HF) and low-fermentable (LF) fiber supplements (NCT03477916). Seventy participants were randomized to the FMT-HF (n = 17), FMT-LF (n = 17), HF (n = 17) and LF (n = 19) groups. The primary outcome was the assessment of change in insulin sensitivity from baseline to 6 weeks using the homeostatic model assessment (HOMA2-IR/IS). After 6 weeks, only patients in the FMT-LF group had significant improvements in HOMA2-IR (3.16 ± 3.01 at 6 weeks versus 3.77 ± 3.57 at baseline; P = 0.02). No difference in HOMA2-IR was observed over this period for those in the FMT-HF group (3.25 ± 1.70 at 6 weeks versus 3.17 ± 1.72 at baseline; P = 0.8), the HF group (3.49 ± 1.43 at 6 weeks versus 3.26 ± 1.33 at baseline; P = 0.8) or the LF group (3.76 ± 2.01 at 6 weeks versus 3.56 ± 1.81 at baseline; P = 0.8). Interventions were safe and well-tolerated with no treatment-attributed serious adverse events. We provide proof of concept for the use of a single-dose oral FMT combined with daily low-fermentable fiber supplementation to improve insulin sensitivity in patients with severe obesity and metabolic syndrome.
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Affiliation(s)
- Valentin Mocanu
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Zhengxiao Zhang
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.,College of Food and Biological Engineering, Jimei University, Xiamen, China
| | - Edward C Deehan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Dina H Kao
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Shahzeer Karmali
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Daniel W Birch
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | | | - Jens Walter
- APC Microbiome Ireland, School of Microbiology and Department of Medicine, University College Cork, Cork, Ireland
| | - Karen L Madsen
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
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11
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Mocanu V, Park H, Dang J, Hotte N, Thiesen A, Laffin M, Wang H, Birch D, Madsen K. Timing of Tributyrin Supplementation Differentially Modulates Gastrointestinal Inflammation and Gut Microbial Recolonization Following Murine Ileocecal Resection. Nutrients 2021; 13:nu13062069. [PMID: 34204288 PMCID: PMC8233937 DOI: 10.3390/nu13062069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Gastrointestinal surgery imparts dramatic and lasting imbalances, or dysbiosis, to the composition of finely tuned microbial ecosystems. The aim of the present study was to use a mouse ileocecal resection (ICR) model to determine if tributyrin (TBT) supplementation could prevent the onset of microbial dysbiosis or alternatively enhance the recovery of the gut microbiota and reduce gastrointestinal inflammation. METHODS Male wild-type (129 s1/SvlmJ) mice aged 8-15 weeks were separated into single cages and randomized 1:1:1:1 to each of the four experimental groups: control (CTR), preoperative TBT supplementation (PRE), postoperative TBT supplementation (POS), and combined pre- and postoperative supplementation (TOT). ICR was performed one week from baseline assessment with mice assessed at 1, 2, 3, and 4 weeks postoperatively. Primary outcomes included evaluating changes to gut microbial communities occurring from ICR to 4 weeks. RESULTS A total of 34 mice that underwent ICR (CTR n = 9; PRE n = 10; POS n = 9; TOT n = 6) and reached the primary endpoint were included in the analysis. Postoperative TBT supplementation was associated with an increased recolonization and abundance of anaerobic taxa including Bacteroides thetaiotomicorn, Bacteroides caecimuris, Parabacteroides distasonis, and Clostridia. The microbial recolonization of PRE mice was characterized by a bloom of aerotolerant organisms including Staphylococcus, Lactobacillus, Enteroccaceae, and Peptostreptococcacea. PRE mice had a trend towards decreased ileal inflammation as evidenced by decreased levels of IL-1β (p = 0.09), IL-6 (p = 0.03), and TNF-α (p < 0.05) compared with mice receiving TBT postoperatively. In contrast, POS mice had trends towards reduced colonic inflammation demonstrated by decreased levels of IL-6 (p = 0.07) and TNF-α (p = 0.07). These changes occurred in the absence of changes to fecal short-chain fatty acid concentrations or histologic injury scoring. CONCLUSIONS Taken together, the results of our work demonstrate that the timing of tributyrin supplementation differentially modulates gastrointestinal inflammation and gut microbial recolonization following murine ICR.
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Affiliation(s)
- Valentin Mocanu
- Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada; (J.D.); (M.L.); (H.W.); (D.B.)
- Correspondence:
| | - Heekuk Park
- Columbia University Medical Center, New York, NY 10032, USA;
| | - Jerry Dang
- Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada; (J.D.); (M.L.); (H.W.); (D.B.)
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Aducio Thiesen
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Michael Laffin
- Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada; (J.D.); (M.L.); (H.W.); (D.B.)
| | - Haili Wang
- Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada; (J.D.); (M.L.); (H.W.); (D.B.)
| | - Daniel Birch
- Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada; (J.D.); (M.L.); (H.W.); (D.B.)
| | - Karen Madsen
- Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
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12
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Zhang Z, Taylor L, Shommu N, Ghosh S, Reimer R, Panaccione R, Kaur S, Hyun JE, Cai C, Deehan EC, Hotte N, Madsen KL, Raman M. Erratum to: A Diversified Dietary Pattern Is Associated With a Balanced Gut Microbial Composition of Faecalibacterium and Escherichia/Shigella in Patients With Crohn's Disease in Remission. J Crohns Colitis 2021; 15:875. [PMID: 33152074 DOI: 10.1093/ecco-jcc/jjaa212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Zhengxiao Zhang
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Lorian Taylor
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Nusrat Shommu
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Subrata Ghosh
- Institute of Translational Medicine, NIHR Biomedical Research Centre, University of Birmingham and Birmingham University Hospitals, Birmingham, UK
| | - Raylene Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Sandeep Kaur
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Jae Eun Hyun
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Chenxi Cai
- Program for Pregnancy and Postpartum Health, Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
| | - Edward C Deehan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton,Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Karen L Madsen
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, Canada
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13
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Madsen K, Dang H, Hotte N, Mocanu V, Ferdaoussi M, Thiesen A, Dyck J. A32 EMPAGLIFOZIN IMPROVES GASTROINTESTINAL INFLAMMATION IN A MOUSE MODEL OF COLITIS. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Empagliflozin (EMPA) is a highly selective sodium glucose cotransporter-2 (SGLT2) inhibitor and is increasingly being utilized as an antihyperglycemic agent in the management of type 2 diabetes. Interestingly, it has been demonstrated in human trials that EMPA treatment exerts potent cardioprotective effects by reducing cardiac inflammation independently of glycemic control. Further, EMPA has also been shown to suppress LPS-induced renal and systemic inflammation in an animal model. Based on these findings, we hypothesized that EMPA treatment may also be effective in reducing gut inflammation.
Aims
The aim of this study was to examine the effects of treatment with EMPA on gastrointestinal inflammation in an animal model of inflammatory bowel disease and to determine mechanistic insights regarding its direct effects on gut cytokine secretion.
Methods
Adult male and female IL-10-/- mice with established colitis were treated with a daily gavage of EMPA (10mg/kg; n=10) or vehicle (n=10) for 14 days. Disease activity was assessed by measurement of mouse weight, colonic weight and length, histological score, cytokine levels in colonic homogenate and lipocalin-2 levels in stool. To examine for possible direct effects of EMPA, colonic explants from wild-type (n=8) and IL-10-/- (n=8) mice were incubated with increasing doses of EMPA (0.1–5 µM) ± LPS (10µg/ml) for 2 hours and tissue levels of IL-1β and TNFα protein measured by ELISA.
Results
After 14 days EMPA treated IL-10-/- mice had a significant improvement in colonic inflammation as evidenced by decreased colonic weight to length ratio (p=0.019), decreased fecal lipocalin-2 (p=0.03), as well as decreased enterocyte injury (p=0.01), decreased lamina propria neutrophils (p=0.01) and decreased total histological score (p=0.006). EMPA treated mice also maintained their weight over the 14 days while untreated mice continued to lose weight (p=0.04). There were no significant differences in colonic homogenate levels of TNFα, IL-1β, or IL-6 or in blood glucose levels between EMPA-treated mice and controls. In addition, EMPA did not suppress levels of basal or LPS-induced TNFα and IL-1β in colonic explants from either wild-type or IL-10-/- mice suggesting that the beneficial effects in IL-10-/- mice were not due to direct effects of EMPA on colonic TNFα or IL-1β cytokine levels.
Conclusions
EMPA treatment dramatically improved histologic and fecal inflammatory markers and maintained body weight in adult IL-10-/- mice with established colitis. These findings suggest further investigations into the effects of EMPA in treating gut inflammation are warranted.
Funding Agencies
CAG, CIHR
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Affiliation(s)
- K Madsen
- University of Alberta, Edmonton, AB, Canada
| | - H Dang
- University of Alberta, Edmonton, AB, Canada
| | - N Hotte
- University of Alberta, Edmonton, AB, Canada
| | - V Mocanu
- Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - A Thiesen
- University of Alberta, Edmonton, AB, Canada
| | - J Dyck
- University of Alberta, Edmonton, AB, Canada
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14
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Mocanu V, Zhang Z, Deehan E, Samarasinghe K, Hotte N, Kao DH, Karmali S, Birch DW, Walter J, Madsen K. A16 FIBER SUPPLEMENTATION DIFFERENTIALLY MODULATES RESPONSES TO FECAL MICROBIAL TRANSPLANTATION IN PATIENTS WITH METABOLIC SYNDROME AND SEVERE OBESITY: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED PILOT TRIAL. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fecal microbial transplantation (FMT) from lean donors to obese patients with metabolic syndrome (MS) has been associated with promising yet short-term metabolic improvements. The concept of using dietary or fiber supplementation to enhance effects induced by FMT has been much discussed in the literature, but to date no human trials have examined this concept.
Aims
The aim of this study was to determine if fiber supplementation following FMT was able to enhance or sustain FMT-mediated metabolic benefits.
Methods
We performed a 12-wk double-blind randomized placebo-controlled trial in patients with severe obesity and MS recruited from Edmonton’s Bariatric Clinic from 2018 to 2019. Patients were stratified by sex and block randomized 1:1:1:1 amongst one of four groups: (1) Placebo FMT and a non-fermentable fiber (NF) (2) Placebo FMT and fermentable fiber (FF); (3) FMT and non-fermentable fiber (FMT-NF); and (4) FMT and fermentable fiber (FMT-FF). Patients received a single dose of FMT (50g donor stool) with 20 oral capsules followed by a 6-wk period of daily fiber. The primary outcome was evaluating mean differences (MD) in insulin sensitivity from baseline to 6-wks using the homeostatic model assessment of insulin resistance (HOMA2-IR).
Results
Sixty-eight patients were randomized with 61 completing the primary outcome (NF = 17; FF = 15; FMT-NF = 14; FMT-FF = 15) and evaluated using a modified intent-to-treat analysis. Baseline characteristics were similar with a mean BMI 45 ± 7 kg/m2, a female predominance (83.6%), and a HOMA2-IR of 3.43 ± 2.2. There were no baseline differences in clinical characteristics, metabolic parameters, medications, or dietary intake. FMT-NF had improvements in HOMA2-IR (MD -24.0% ± 12.0%; p=0.02), insulin sensitivity (MD 27.6% ± 12.3%; p=0.02), and insulinemia (MD -25.4% ± 12.3%; p=0.02) from baseline to 6-wks (Figure 1). These benefits were associated with increased microbial richness and improvements in GLP-1 metabolism. Linear mixed model regression revealed that select bacterial taxa including Phascolarctobacterium, Ruminococcaeceae, and B. stercoris correlated with increased insulin sensitivity. Findings occurred in the absence of changes in anthropometric parameters, dietary intake, medication regimen and were not observed in groups receiving fermentable fiber or in any group following cessation of fiber.
Conclusions
This proof-of-concept trial provides evidence that a single FMT dose combined with daily non-fermentable fiber supplementation can successfully improve insulin resistance in patients with metabolic syndrome and severe obesity on optimized medical therapy.
Funding Agencies
W. Garfield Weston Foundation
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Affiliation(s)
- V Mocanu
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - Z Zhang
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - E Deehan
- Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - N Hotte
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - D H Kao
- University of Alberta, Edmonton, AB, Canada
| | - S Karmali
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - D W Birch
- Surgery, University of Alberta, Edmonton, AB, Canada
| | - J Walter
- University College Cork, Cork, Cork, Ireland
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
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15
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Zhang Z, Taylor L, Shommu N, Ghosh S, Reimer R, Panaccione R, Kaur S, Hyun JE, Cai C, Deehan EC, Hotte N, Madsen KL, Raman M. A Diversified Dietary Pattern Is Associated With a Balanced Gut Microbial Composition of Faecalibacterium and Escherichia/Shigella in Patients With Crohn's Disease in Remission. J Crohns Colitis 2020; 14:1547-1557. [PMID: 32343765 DOI: 10.1093/ecco-jcc/jjaa084] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Crohn's disease [CD] is associated with alterations in gut microbial composition and function. The present controlled-intervention study investigated the relationship between patterns of dietary intake and baseline gut microbiota in CD patients in remission and examined the effects of a dietary intervention in patients consuming a non-diversified diet [NDD]. METHODS Forty outpatients with quiescent CD were recruited in Calgary, Alberta, Canada. Based on 3-day food records, patients consuming a lower plant-based and higher red and processed meat-based diet were assigned to the NDD group [n = 15] and received a 12-week structured dietary intervention; all other patients were assigned to the diversified diet [DD] control group [n = 25] and received conventional management. Faecal microbiota composition, short chain fatty acids [SCFAs] and calprotectin were measured. RESULTS At baseline the NDD and DD groups had a different faecal microbial beta-diversity [p = 0.003, permutational multivariate analysis of variance]. The NDD group had lower Faecalibacterium and higher Escherichia/Shigella relative abundances compared to the DD group [3.3 ± 5.4% vs. 8.5 ± 10.6%; 6.9 ± 12.2% vs. 1.6 ± 4.4%; p ≤ 0.03, analysis of covariance]. These two genera showed a strong negative correlation [rs = -0.60, q = 0.0002]. Faecal butyrate showed a positive correlation with Faecalibacterium [rs = 0.52, q = 0.002], and an inhibitory relationship with Escherichia/Shigella abundance [four-parameter sigmoidal model, R = -0.83; rs = -0.44, q = 0.01], respectively. After the 12 weeks of dietary intervention, no difference in microbial beta-diversity between the two groups was observed [p = 0.43]. The NDD group demonstrated an increase in Faecalibacterium [p < 0.05, generalized estimated equation model], and resembled the DD group at the end of the intervention [p = 0.84, t-test with permutation]. We did not find an association of diet with faecal SCFAs or calprotectin. CONCLUSIONS Dietary patterns are associated with specific gut microbial compositions in CD patients in remission. A diet intervention in patients consuming a NDD modifies gut microbial composition to resemble that seen in patients consuming a DD. These results show that diet is important in shaping the microbial dysbiosis signature in CD towards a balanced community.
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Affiliation(s)
- Zhengxiao Zhang
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lorian Taylor
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nusrat Shommu
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Subrata Ghosh
- Institute of Translational Medicine, NIHR Biomedical Research Centre, University of Birmingham and Birmingham University Hospitals, Birmingham, UK
| | - Raylene Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sandeep Kaur
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jae Eun Hyun
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Chenxi Cai
- Program for Pregnancy and Postpartum Health, Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
| | - Edward C Deehan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Karen L Madsen
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, AB, Canada
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16
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Kozicky LK, Menzies SC, Hotte N, Madsen KL, Sly LM. Intravenous immunoglobulin (IVIg) or IVIg-treated macrophages reduce DSS-induced colitis by inducing macrophage IL-10 production. Eur J Immunol 2019; 49:1251-1268. [PMID: 31054259 DOI: 10.1002/eji.201848014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/24/2019] [Accepted: 05/02/2019] [Indexed: 12/19/2022]
Abstract
Intravenous immunoglobulin (IVIg) is used to treat immune-mediated diseases but its mechanism of action is poorly understood. We have reported that co-treatment with IVIg and lipopolysaccharide activates macrophages to produce large amounts of anti-inflammatory IL-10 in vitro. Thus, we asked whether IVIg-treated macrophages or IVIg could reduce intestinal inflammation in mice during dextran sulfate sodium (DSS)-induced colitis by inducing macrophage IL-10 production in vivo. Adoptive transfer of IVIg-treated macrophages reduces intestinal inflammation in mice and collagen accumulation post-DSS. IVIg treatment also reduces DSS-induced intestinal inflammation and its activity is dependent on the Fc portion of the antibody. Ex vivo, IVIg induces IL-10 production and reduces IL-12/23p40 and IL-1β production in colon explant cultures. Co-staining tissues for mRNA, we demonstrate that macrophages are the source of IL-10 in IVIg-treated mice; and using IL-10-GFP reporter mice, we demonstrate that IVIg induces IL-10 production by intestinal macrophages. Finally, IVIg-mediated protection is lost in mice deficient in macrophage IL-10 production (LysMcre+/- IL-10fl/fl mice). Together, our data demonstrate a novel, in vivo mechanism of action for IVIg. IVIg-treated macrophages or IVIg could be used to treat people with intestinal inflammation and may be particularly useful for people with inflammatory bowel disease, who are refractory to therapy.
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Affiliation(s)
- Lisa K Kozicky
- Department of Pediatrics, Division of Gastroenterology, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Susan C Menzies
- Department of Pediatrics, Division of Gastroenterology, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Naomi Hotte
- Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | - Karen L Madsen
- Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | - Laura M Sly
- Department of Pediatrics, Division of Gastroenterology, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
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17
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Rajaruban S, Fedorak R, Zalasky A, Hotte N, Laffin M, Hyun J, Ma W, Madsen K. A77 CONSUMPTION OF REFINED SUGAR RAPIDLY DECREASES MICROBIAL DIVERSITY AND ENHANCES SYSTEMIC RESPONSE TO MICROBIAL STIMULI. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - R Fedorak
- University of Alberta, Edmonton, AB, Canada
| | - A Zalasky
- University of Alberta, Edmonton, AB, Canada
| | - N Hotte
- University of Alberta, Edmonton, AB, Canada
| | - M Laffin
- University of Alberta, Edmonton, AB, Canada
| | - J Hyun
- University of Alberta, Edmonton, AB, Canada
| | - W Ma
- University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
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18
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Park H, Laffin MR, Jovel J, Millan B, Hyun JE, Hotte N, Kao D, Madsen KL. The success of fecal microbial transplantation in Clostridium difficile infection correlates with bacteriophage relative abundance in the donor: a retrospective cohort study. Gut Microbes 2019; 10:676-687. [PMID: 30866714 PMCID: PMC6867182 DOI: 10.1080/19490976.2019.1586037] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Fecal microbial transplantation (FMT) is used in the treatment of relapsing Clostridium difficile infection (rCDI). Failure rate for FMT is as high as 10% but the mechanisms contributing to a failed FMT are not understood. We utilized metagenomic data to identify the role of bacteria and bacteriophages on FMT success.Results: Subjects with rCDI (n = 19) received FMT from volunteer donors (n = 7) via colonoscopy. Twelve patients fully recovered after a single FMT, while seven patients required a subsequent FMT. DNA was extracted from patient and donor stool samples for shotgun metagenomic analysis. Metagenomics libraries were analyzed focusing on bacterial taxonomy and bacteriophage sequences. Gammaproteobacteria were dominant in rCDI patients prior to FMT largely due to elevated levels of Klebsiella and Escherichia. A successful FMT led to increased levels of Clostridia and Bacteroidia and a reduction in Gammaproteobacteria. In contrast, a failed FMT led to no significant changes in bacterial composition. Bacteriophages were classified during whole metagenomic analysis of each sample and were markedly different between rCDI patients, donors, and a healthy control cohort (n = 96). Bacteriophage sequence reads were increased in CDI patients compared with donors and healthy controls. Successful FMT donors had higher bacteriophage α-diversity and lower relative abundance compared to the donors of a failed initial FMT.Conclusions: In this retrospective analysis, FMTs with increased bacteriophage α-diversity were more likely to successfully treat rCDI. In addition, the relative number of bacteriophage reads was lower in donations leading to a successful FMT. These results suggest that bacteriophage abundance may have some role in determining the relative success of FMT.
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Affiliation(s)
- Heekuk Park
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada
| | | | - Juan Jovel
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada
| | - Braden Millan
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada
| | - Jae E. Hyun
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada
| | - Naomi Hotte
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada
| | - Dina Kao
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada
| | - Karen L. Madsen
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada,Center of Excellence for Gastrointestinal Inflammation and Immunity Research, Edmonton, AB, Canada,CONTACT Karen L. Madsen Division of Gastroenterology, Department of Medicine, University of Alberta, 7-142 Katz Group Center, Edmonton, AB, Canada
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19
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Meng X, Dunsmore G, Koleva P, Elloumi Y, Wu RY, Sutton RT, Ambrosio L, Hotte N, Nguyen V, Madsen KL, Dieleman LA, Chen H, Huang V, Elahi S. The Profile of Human Milk Metabolome, Cytokines, and Antibodies in Inflammatory Bowel Diseases Versus Healthy Mothers, and Potential Impact on the Newborn. J Crohns Colitis 2019; 13:431-441. [PMID: 30418545 PMCID: PMC6441305 DOI: 10.1093/ecco-jcc/jjy186] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS For women with inflammatory bowel disease [IBD], it is not very well known how IBD or IBD treatment affects their breast milk components. We aimed to investigate whether breast milk composition differs in healthy control [HC] versus IBD mothers in terms of antibodies, cytokines, and metabolite,s to identify potential impact of IBD breast milk on neonatal immune system. METHODS Breast milk specimens from HC [n = 17] and IBD [n = 31 for Crohn's disease [CD]; and n = 41 for ulcerative colitis [UC]; were collected at 3 and 6 months postpartum [PP3] and [PP6], respectively. Faecal samples were also collected. Cytokines and immunoglobulins [IgA/IgG/IgE] were analysed by multiplex Meso Scale Discovery [MSD] and commercial kits. Moreover, breast milk metabolites were analysed by 1H nuclear magnetic resonance [NMR]. RESULTS We found that breast milk from IBD mothers showed significantly lower levels of IgA, sugar metabolite [lactose], and 2-aminobutyrate. In contrast, we observed that breast milk from mothers with IBD had increased levels of pro-inflammatory cytokines and higher energy metabolites [lactate and succinate] than milk from healthy mothers. In addition, we noticed that the type of treatment [5-aminosalicylic acid versus biologics] influenced the milk cytokines and metabolites profile. CONCLUSIONS The reduction in immunoprotective components of IBD breast milk such as sIgA and lactose theoretically may modulate the potential protective effects of breastfeeding. On the other hand, presence of higher levels of pro-inflammatory cytokines, lactate, and succinate may predispose the offspring to an inflammatory condition or impact on the gut microbiome. Better understanding of the role of succinate in infants and its potential effects on microbiome or mucosal immunity merits further investigations.
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Affiliation(s)
- Xuanyi Meng
- Department of Dentistry, University of Alberta, Edmonton, AB, Canada,State Key Laboratory of Food Science and Technology, Nanchang University. Nanchang, China
| | - Garett Dunsmore
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Petya Koleva
- Department of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Yesmine Elloumi
- Division of Gastroenterology, University of Alberta, AB, Canada
| | - Richard You Wu
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Lindsy Ambrosio
- Division of Gastroenterology, University of Alberta, AB, Canada
| | - Naomi Hotte
- Division of Gastroenterology, University of Alberta, AB, Canada
| | - Vivian Nguyen
- Division of Gastroenterology, University of Alberta, AB, Canada
| | - Karen L Madsen
- Division of Gastroenterology, University of Alberta, AB, Canada
| | | | - Hongbing Chen
- State Key Laboratory of Food Science and Technology, Nanchang University. Nanchang, China
| | - Vivian Huang
- Division of Gastroenterology, University of Alberta, AB, Canada,Division of Gastroenterology, University of Toronto, Mount Sinai Hospital, Toronto, ON, Canada
| | - Shokrollah Elahi
- Department of Dentistry, University of Alberta, Edmonton, AB, Canada,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada,Corresponding author: Shokrollah Elahi, PhD, 7020L, Katz Group Centre for Pharmacology and Health Research, 11361-87th Ave NW, Edmonton, AB, T6G2E1, Canada. Tel.: 780-492-1336; fax: 780-492-7466;
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20
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Dunsmore G, Koleva P, Ghobakhloo N, Sutton R, Ambrosio L, Meng X, Hotte N, Nguyen V, Madsen KL, Dieleman LA, Huang V, Elahi S. Lower Abundance and Impaired Function of CD71+ Erythroid Cells in Inflammatory Bowel Disease Patients During Pregnancy. J Crohns Colitis 2019; 13:230-244. [PMID: 30272151 PMCID: PMC6357902 DOI: 10.1093/ecco-jcc/jjy147] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS CD71+ erythroid cells are enriched during pregnancy with immuno suppressive properties. We investigated the frequency and functionality of CD71+ erythroid cells in peripheral blood, cord blood, and placenta of inflammatory bowel disease [IBD] patients versus healthy controls [HCs]. We aimed to determine their role in IBD pathogenesis during pregnancy. METHODS Peripheral blood was collected at preconception, the first, second and third trimesters, and postpartum. Cord blood and placental tissues were collected at the time of birth. Cells from different specimens were subjected to immune-phenotyping and functional assays. CD71+ erythroid cells were purified for quantitative polymerase chain reaction [qPCR] analysis. Using an allogeneic mouse model of pregnancy, the effects of CD71+ erythroid cells depletion on intestinal homeostasis and dysbiosis was studied. RESULTS IBD patients had lower CD71+ erythroid cells during pregnancy compared with HCs. Placenta and cord blood CD71+ erythroid cells from IBD patients exhibited impaired functionality and expressed lower inhibitory molecules including VISTA, TGF-β, and reactive oxygen species [ROS]. Lower CD71+ erythroid cells were correlated with reduced regulatory T cells and increased immune-activation in IBD patients. Depletion of CD71+ erythroid cells in an allogeneic pregnancy model resulted in upregulation of TLRs, IL-6, and CXCL-1, and enhanced production of TNF-α, in intestinal tissues. In contrast, TGF-β gene expression was reduced. Excessive inflammatory response in the gut [e.g. TNF-α] affects intestinal integrity and CD71+ erythroid cells impact on the gut's bacterial composition. CONCLUSIONS Reduced frequency and/or impaired functionality of CD71+ erythroid cells during pregnancy may predispose IBD patients to a more pro-inflammatory milieu in their gastrointestinal tract, characterised by lower Tregs, higher IL-6, and TNF-α, and dysbiosis.
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Affiliation(s)
- Garett Dunsmore
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada,Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Petya Koleva
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Nafiseh Ghobakhloo
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada,Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Reed Sutton
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Lindsy Ambrosio
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Xuanyi Meng
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Naomi Hotte
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Vivian Nguyen
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Karen L Madsen
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Levinus A Dieleman
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Vivian Huang
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada,Division of Gastroenterology, University of Toronto, Mount Sinai Hospital, Toronto, ON, Canada
| | - Shokrollah Elahi
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada,Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada,Corresponding author: Shokrollah Elahi, PhD, 7020L, Katz Group Centre for Pharmacology and Health Research, 11361-87th Ave NW, Edmonton, AB, T6G2E1, Canada. Tel.: 780-492-1336; fax: 780-492-7466;
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21
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Keshteli AH, Hoevers T, Madsen K, Hotte N, Nickurak C, Kroeker KI, van Den Brand F, Valcheva RS, Fedorak R, Dieleman LA. A84 HIGH FECAL CALPROTECTIN LEVELS IN ULCERATIVE COLITIS PATIENTS IN CLINICAL REMISSION ARE ASSOCIATED WITH SPECIFIC CLINICAL AND DIETARY INTAKE PARAMETERS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A H Keshteli
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - T Hoevers
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - N Hotte
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - C Nickurak
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - K I Kroeker
- Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - R S Valcheva
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - R Fedorak
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - L A Dieleman
- Medicine, University of Alberta, Edmonton, AB, Canada
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22
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Nguyen VV, Ambrosio L, Dunsmore G, Agrawal A, Hotte N, Dieleman LA, Halloran BP, Kroeker KI, Fedorak R, elahi S, Madsen K, Huang V. A145 BREASTFEEDING INCREASES COLONIC INFLAMMATION IN INFANTS BORN FROM HEALTHY MOMS, WHICH EFFECT IS LACKING IN INFANTS BORN FROM MOMS WITH IBD. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V V Nguyen
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - L Ambrosio
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - G Dunsmore
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - A Agrawal
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - N Hotte
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - L A Dieleman
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - B P Halloran
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - K I Kroeker
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - R Fedorak
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - S elahi
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - V Huang
- Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
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Laffin M, Perry T, Hotte N, Park H, Fedorak R, Dicken B, Madsen K. A5 FRUCTOOLIGOSACCHARIDE EXACERBATES INFLAMMATION AND THE LOSS OF MICROBIAL DIVERSITY FOLLOWING ILEOCECAL RESECTION IN A MURINE MODEL OF POST-OPERATIVE CROHN’S DISEASE RECURRENCE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Laffin
- University of Alberta, Edmonton, AB, Canada
| | - T Perry
- University of Alberta, Edmonton, AB, Canada
| | - N Hotte
- University of Alberta, Edmonton, AB, Canada
| | - H Park
- University of Alberta, Edmonton, AB, Canada
| | - R Fedorak
- University of Alberta, Edmonton, AB, Canada
| | - B Dicken
- University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
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Park H, Millan BT, Hotte N, Kao DH, Madsen K. A11 EFFECT OF FECAL MICROBIAL TRANSPLANT ON MICROBIAL AND PHAGE COMPOSITION IN PATIENTS WITH CLOSTRIDIUM DIFFICILE INFECTION. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Park
- University of Alberta, Edmonton, AB, Canada
| | - B T Millan
- University of Calgary, Calgary, AB, Canada
| | - N Hotte
- University of Alberta, Edmonton, AB, Canada
| | - D H Kao
- University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
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25
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Gill A, Fedorak R, Park H, Hotte N, Ginter R, Keshteli AH, Madsen K. A9 SHORT-TERM EXPOSURE TO A HIGH SUGAR DIET REDUCES SHORT CHAIN FATTY ACID PRODUCTION AND INCREASES SUSCEPTIBILITY TO COLITIS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Gill
- University of Alberta, Edmonton, AB, Canada
| | - R Fedorak
- University of Alberta, Edmonton, AB, Canada
| | - H Park
- University of Alberta, Edmonton, AB, Canada
| | - N Hotte
- University of Alberta, Edmonton, AB, Canada
| | - R Ginter
- University of Alberta, Edmonton, AB, Canada
| | - A Hassanzadeh Keshteli
- Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, AB, Canada
| | - K Madsen
- Medicine, University of Alberta, Edmonton, AB, Canada
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26
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Laffin M, Perry T, Park H, Hotte N, Fedorak RN, Thiesen A, Dicken B, Madsen KL. Prebiotic Supplementation Following Ileocecal Resection in a Murine Model is Associated With a Loss of Microbial Diversity and Increased Inflammation. Inflamm Bowel Dis 2018; 24:101-110. [PMID: 29272494 PMCID: PMC6176898 DOI: 10.1093/ibd/izx033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals with Crohn's disease frequently require ileocecal resection (ICR), and inflammation often recurs in the neoterminal ileum following surgery. Fructooligosaccharide (FOS) is a fermentable prebiotic that stimulates the growth of bifidobacteria and may promote anti-inflammatory activity. The aim of this study was to determine if supplementation of a postICR diet with FOS in a mouse model would be effective in stimulating the growth of bifidobacteria and reducing systemic and local inflammation. METHODS ICR was performed in IL10-/- mice (129S1/SvlmJ) with colitis. Following surgery, nonICR control and ICR mice were fed a chow diet ± 10% FOS for 28 days. Serum, colon, and terminal ileum (TI) were analyzed for cytokine expression by MesoScale discovery platform. DNA extracted from stool was analyzed using 16s rRNA sequencing and qPCR. Expression of occludin and ZO1 was assessed using qPCR. Short-chain fatty acid (SCFA) concentrations were assessed using gas chromatography. RESULTS ICR led to increased systemic inflammation (P < 0.05) and a significant decline in fecal microbial diversity (P < 0.05). Mice on the FOS diet had a greater reduction in microbial diversity and also had worsened inflammation as evidenced by increased serum IL-6 (P < 0.05) and colonic IFNγ and TNFα (P < 0.05). Expression of occludin and ZO1 were significantly reduced in FOS-supplemented mice. There was a correlation between loss of diversity and the bifidogenic effectiveness of FOS (r = -0.61, P < 0.05). CONCLUSIONS FOS-supplementation of a postICR diet resulted in a decrease in fecal bacterial diversity, reduction in barrier function, and increased gut inflammation.
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Affiliation(s)
| | - Troy Perry
- Department of Surgery, University of Alberta
| | - Heekuk Park
- Department of Medicine, University of Alberta,The Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta
| | - Naomi Hotte
- The Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta
| | - Richard N Fedorak
- Department of Medicine, University of Alberta,The Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta
| | - Aducio Thiesen
- Department of Laboratory Medicine, University of Alberta
| | | | - Karen L Madsen
- Department of Medicine, University of Alberta,The Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta,Address correspondence to: Karen L. Madsen, PhD, 7-142K Katz Building, University of Alberta, Edmonton, Alberta T6G 2E1. E-mail:
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27
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Jovel J, Patterson J, Wang W, Hotte N, O'Keefe S, Mitchel T, Perry T, Kao D, Mason AL, Madsen KL, Wong GKS. Characterization of the Gut Microbiome Using 16S or Shotgun Metagenomics. Front Microbiol 2016; 7:459. [PMID: 27148170 PMCID: PMC4837688 DOI: 10.3389/fmicb.2016.00459] [Citation(s) in RCA: 496] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/21/2016] [Indexed: 02/06/2023] Open
Abstract
The advent of next generation sequencing (NGS) has enabled investigations of the gut microbiome with unprecedented resolution and throughput. This has stimulated the development of sophisticated bioinformatics tools to analyze the massive amounts of data generated. Researchers therefore need a clear understanding of the key concepts required for the design, execution and interpretation of NGS experiments on microbiomes. We conducted a literature review and used our own data to determine which approaches work best. The two main approaches for analyzing the microbiome, 16S ribosomal RNA (rRNA) gene amplicons and shotgun metagenomics, are illustrated with analyses of libraries designed to highlight their strengths and weaknesses. Several methods for taxonomic classification of bacterial sequences are discussed. We present simulations to assess the number of sequences that are required to perform reliable appraisals of bacterial community structure. To the extent that fluctuations in the diversity of gut bacterial populations correlate with health and disease, we emphasize various techniques for the analysis of bacterial communities within samples (α-diversity) and between samples (β-diversity). Finally, we demonstrate techniques to infer the metabolic capabilities of a bacteria community from these 16S and shotgun data.
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Affiliation(s)
- Juan Jovel
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Jordan Patterson
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Weiwei Wang
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Naomi Hotte
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Sandra O'Keefe
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Troy Mitchel
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Troy Perry
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Dina Kao
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Andrew L. Mason
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Karen L. Madsen
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Gane K.-S. Wong
- Department of Medicine, University of AlbertaEdmonton, AB, Canada
- Department of Biological Sciences, University of AlbertaEdmonton, AB, Canada
- BGI-ShenzhenShenzhen, China
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28
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Millan B, Park H, Hotte N, Mathieu O, Burguiere P, Tompkins TA, Kao D, Madsen KL. Fecal Microbial Transplants Reduce Antibiotic-resistant Genes in Patients With Recurrent Clostridium difficile Infection. Clin Infect Dis 2016; 62:1479-1486. [PMID: 27025836 PMCID: PMC4885654 DOI: 10.1093/cid/ciw185] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/15/2016] [Indexed: 01/13/2023] Open
Abstract
Patients with recurrent C. difficile infection harbor large numbers of microbes with antibiotic resistance genes. Fecal microbial transplantation eradicates pathogenic organisms and eliminates antibiotic-resistance genes suggesting this may be a viable treatment option to eradicate multidrug resistant bacteria from patients. Background. Recurrent Clostridium difficile infection (RCDI) is associated with repeated antibiotic treatment and the enhanced growth of antibiotic-resistant microbes. This study tested the hypothesis that patients with RCDI would harbor large numbers of antibiotic-resistant microbes and that fecal microbiota transplantation (FMT) would reduce the number of antibiotic-resistant genes. Methods. In a single center study, patients with RCDI (n = 20) received FMT from universal donors via colonoscopy. Stool samples were collected from donors (n = 3) and patients prior to and following FMT. DNA was extracted and shotgun metagenomics performed. Results as well as assembled libraries from a healthy cohort (n = 87) obtained from the Human Microbiome Project were aligned against the NCBI bacterial taxonomy database and the Comprehensive Antibiotic Resistance Database. Results were corroborated through a DNA microarray containing 354 antibiotic resistance (ABR) genes. Results. RCDI patients had a greater number and diversity of ABR genes compared with donors and healthy controls. Beta-lactam, multidrug efflux pumps, fluoroquinolone, and antibiotic inactivation ABR genes were increased in RCDI patients, although donors primarily had tetracycline resistance. RCDI patients were dominated by Proteobacteria with Escherichia coli and Klebsiella most prevalent. FMT resulted in a resolution of symptoms that correlated directly with a decreased number and diversity of ABR genes and increased Bacteroidetes and Firmicutes with reduced Proteobacteria. ABR gene profiles were maintained in recipients for up to a year following FMT. Conclusions. RCDI patients have increased numbers of antibiotic-resistant organisms. FMT is effective in the eradication of pathogenic antibiotic-resistant organisms and elimination of ABR genes.
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Affiliation(s)
- Braden Millan
- Department of Medicine, University of Alberta, Edmonton
| | - Heekuk Park
- Department of Medicine, University of Alberta, Edmonton
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton
| | | | | | | | - Dina Kao
- Department of Medicine, University of Alberta, Edmonton
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29
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Kao D, Roach B, Park H, Hotte N, Madsen K, Bain V, Tandon P. Fecal microbiota transplantation in the management of hepatic encephalopathy. Hepatology 2016; 63:339-40. [PMID: 26264779 DOI: 10.1002/hep.28121] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/10/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Dina Kao
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Brandi Roach
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Heekuk Park
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Naomi Hotte
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Karen Madsen
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Vince Bain
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Puneeta Tandon
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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30
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Valcheva R, Hotte N, Gillevet P, Sikaroodi M, Thiessen A, Madsen KL. Soluble Dextrin Fibers Alter the Intestinal Microbiota and Reduce Proinflammatory Cytokine Secretion in Male IL-10-Deficient Mice. J Nutr 2015; 145:2060-6. [PMID: 26180249 DOI: 10.3945/jn.114.207738] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 06/22/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Prebiotic fibers stimulate the growth and activity of the gut microbiota. Interleukin 10-deficient (IL-10(-/-)) mice develop a colitis that is influenced by the gut microbial composition. OBJECTIVE The purpose of this study was to determine the effect of prebiotic fibers on the intestinal microbiota and immune function in IL-10(-/-) mice. METHODS At 4 wk of age, male IL-10(-/-) mice (n = 8/group) were randomly assigned to 5 diets: unpurified diet with cellulose (4%; control), corn-derived hydroxypropylated new resistant starch (NRS) (2% NRS + 2% cellulose), soluble fiber dextrin from tapioca (SFD-t) (4%), soluble fiber dextrin from corn (SFD-c) (4%), or soluble corn fiber (4%) for 12 wk. Growth, small intestinal permeability, histologic injury, intestinal cytokine secretion, and microbiota composition by 16S ribosomal RNA pyrosequencing of stool were measured. ANOVA and principal component analysis were applied to assess the fibers' effects. RESULTS There were no significant differences in mouse growth, intestinal weight, length, or gut permeability over the 12 wk feeding period. Mice fed dextrin-based diets secreted 47-88% less colonic IL-1β, tumor necrosis factor α, and IL-23 (SFD-t diet) and IL-12 heterodimer p70, IL-6, and chemokine ligand 1 (CXCL1) (SFD-c diet) (P < 0.05) than did the control group, whereas NRS-fed mice secreted 55-77% less IL-6 and CXCL1 (P < 0.05). Both SFD-t- and SFD-c-fed mice had a 70-75% lower abundance of Lactobacillaceae than control mice. The SFD-t diet group had a lower enterocyte injury score (P < 0.04) than did control mice, and this was associated with increased abundance of butyrate producers, including Incertae sedis XIV, Lachnospiraceae, and Ruminococcaceae (P < 0.001). CONCLUSIONS These results demonstrate that soluble prebiotic fibers selectively stimulate the growth of a distinctive gut microbiota in IL-10(-/-) mice. SFD-t induced the growth of butyrate-producing microbes and was effective in reducing proinflammatory cytokine secretion and enterocyte injury in this mouse model of colitis.
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Affiliation(s)
| | | | - Patrick Gillevet
- Department of Environmental Science, George Mason University, Fairfax, VA
| | - Masoumeh Sikaroodi
- Department of Environmental Science, George Mason University, Fairfax, VA
| | - Aducio Thiessen
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada; and
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31
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Kozicky LK, Zhao ZY, Menzies SC, Fidanza M, Reid GSD, Wilhelmsen K, Hellman J, Hotte N, Madsen KL, Sly LM. Intravenous immunoglobulin skews macrophages to an anti-inflammatory, IL-10-producing activation state. J Leukoc Biol 2015. [PMID: 26216934 DOI: 10.1189/jlb.3vma0315-078r] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Intravenous Ig is used to treat autoimmune or autoinflammatory disorders, but the mechanism by which it exerts its immunosuppressive activity is not understood completely. To examine the impact of intravenous Ig on macrophages, we compared cytokine production by LPS-activated macrophages in the presence and absence of intravenous Ig. Intravenous Ig treatment induced robust production of IL-10 in response to LPS, relative to LPS stimulation alone, and reduced production of proinflammatory cytokines. This anti-inflammatory, intravenous Ig-induced activation was sustained for 24 h but could only be induced if intravenous Ig were provided within 1 h of LPS stimulation. Intravenous Ig activation led to enhanced and prolonged activation of MAPKs, Erk1/2, p38, and Erk5, and inhibition of each reduced intravenous Ig-induced IL-10 production and suppression of IL-12/23p40. IL-10 production occurred rapidly in response to intravenous Ig + LPS and was sufficient to reduce proinflammatory IL-12/23p40 production in response to LPS. IL-10 induction and reduced IL-12/23p40 production were transcriptionally regulated. IL-10 played a direct role in reducing proinflammatory cytokine production by macrophages treated with intravenous Ig + LPS, as macrophages from mice deficient in the IL-10R β chain or in IL-10 were compromised in their ability to reduce proinflammatory cytokine production. Finally, intraperitoneal injection of intravenous Ig or intravenous Ig + LPS into mice activated macrophages to produce high levels of IL-10 during subsequent or concurrent LPS challenge, respectively. These findings identify IL-10 as a key anti-inflammatory mediator produced by intravenous Ig-treated macrophages and provide insight into a novel mechanism by which intravenous Ig may dampen down inflammatory responses in patients with autoimmune or autoinflammatory diseases.
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Affiliation(s)
- Lisa K Kozicky
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Zheng Yu Zhao
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Susan C Menzies
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mario Fidanza
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Gregor S D Reid
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin Wilhelmsen
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Judith Hellman
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Naomi Hotte
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Karen L Madsen
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Laura M Sly
- *Division of Gastroenterology and Division of Oncology, Hematology, and Blood and Marrow Transplantation, Department of Pediatrics, Michael Cuccione Childhood Cancer Research Program, Child & Family Research Institute, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California, USA; and Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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32
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Fedorak RN, Feagan BG, Hotte N, Leddin D, Dieleman LA, Petrunia DM, Enns R, Bitton A, Chiba N, Paré P, Rostom A, Marshall J, Depew W, Bernstein CN, Panaccione R, Aumais G, Steinhart AH, Cockeram A, Bailey RJ, Gionchetti P, Wong C, Madsen K. The probiotic VSL#3 has anti-inflammatory effects and could reduce endoscopic recurrence after surgery for Crohn's disease. Clin Gastroenterol Hepatol 2015; 13:928-35.e2. [PMID: 25460016 DOI: 10.1016/j.cgh.2014.10.031] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 09/20/2014] [Accepted: 10/24/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Probiotic formulations of single species of bacteria have not been effective in preventing the recurrence of Crohn's disease after surgery. We investigated the ability of VSL#3, a mixture of 8 different bacterial probiotic species, to prevent Crohn's disease recurrence after surgery in a multicenter, randomized, double-blind, placebo-controlled trial. METHODS Within 30 days of ileocolonic resection and re-anastomosis, patients with Crohn's disease were randomly assigned to groups given 1 sachet of VSL#3 (900 billion viable bacteria, comprising 4 strains of Lactobacillus, 3 strains of Bifidobacterium, and 1 strain of Streptococcus salivarius subspecies thermophilus) (n = 59) or matching placebo (n = 60). Colonoscopy was performed at days 90 and 365 to evaluate the neoterminal ileum for disease recurrence and obtain mucosal biopsies for cytokine analysis. Patients from both groups with either no or mild endoscopic recurrence at day 90 received VSL#3 until day 365. The primary outcome was the proportion of patients with severe endoscopic recurrence at day 90. RESULTS At day 90, the proportion of patients with severe endoscopic lesions did not differ significantly between VSL#3 (9.3%) and placebo (15.7%, P = .19). The proportions of patients with non-severe lesions at day 90 who had severe endoscopic recurrence at day 365 were 10.0% in the early VSL#3 group (given VSL#3 for the entire 365 days) and 26.7% in the late VSL#3 group (given VSL#3 from days 90 through 365) (P = .09). Aggregate rates of severe recurrence (on days 90 and 365) were not statistically different, 20.5% of subjects in the early VSL#3 group and 42.1% in the late VSL#3 group. Patients receiving VSL#3 had reduced mucosal inflammatory cytokine levels compared with placebo at day 90 (P < .05). Crohn's disease activity index and inflammatory bowel disease quality of life scores were similar in the 2 groups. CONCLUSIONS There were no statistical differences in endoscopic recurrence rates at day 90 between patients who received VSL#3 and patients who received placebo. Lower mucosal levels of inflammatory cytokines and a lower rate of recurrence among patients who received early VSL#3 (for the entire 365 days) indicate that this probiotic should be further investigated for prevention of Crohn's disease recurrence. Clinical trials.gov number: NCT00175292.
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Affiliation(s)
- Richard N Fedorak
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.
| | - Brian G Feagan
- Robarts Clinical Trials University of Western Ontario, London, Ontario, Canada
| | - Naomi Hotte
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | - Des Leddin
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Levinus A Dieleman
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Robert Enns
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Naoki Chiba
- Guelph GI and Surgery Clinic, Guelph, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Pierre Paré
- Université Laval, CHA-Hopitâl du Saint-Sacrement, Quebec City, Quebec, Canada
| | - Alaa Rostom
- University of Ottawa, Ottawa, Ontario, Canada
| | | | | | | | | | - Guy Aumais
- University of Montreal, Montreal, Quebec, Canada
| | | | | | - Robert J Bailey
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Cindy Wong
- Robarts Clinical Trials University of Western Ontario, London, Ontario, Canada
| | - Karen Madsen
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
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Jayakumar S, Carbonneau M, Hotte N, Befus AD, St Laurent C, Owen R, McCarthy M, Madsen K, Bailey RJ, Ma M, Bain V, Rioux K, Tandon P. VSL#3 ® probiotic therapy does not reduce portal pressures in patients with decompensated cirrhosis. Liver Int 2013; 33:1470-7. [PMID: 23968203 DOI: 10.1111/liv.12280] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/20/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS In patients with decompensated cirrhosis, bacterial translocation can contribute to splanchnic vasodilatation, decreased effective circulating volume, and portal hypertension. The primary objective of this randomized, double blind placebo controlled trial was to evaluate the effect of the probiotic VSL#3(®) on the hepatic venous pressure gradient (HVPG). METHODS Seventeen patients with decompensated cirrhosis and an HVPG of ≥ 10 mmHg were randomized to receive 2 months of VSL#3(®) or an identical placebo. HVPG, endotoxin, interleukin (IL)-6, IL-8, IL-10, renin, aldosterone, nitric oxide and stool microbiota were measured at baseline and study end. RESULTS Two of the 17 patients were taken off the trial before completion (one for alcohol abuse and the second for SBP - both in placebo arm). Data were analysed on the remaining 15 patients. The median model for end-stage liver disease score was 12, and 80% of patients had Child Pugh B disease. The treatment arm had a greater decrease in HVPG from baseline to study end than the placebo arm (median change from baseline -11.6% vs +2.8%), although this reduction was not statistically significant in either group. There was a significant reduction in the plasma aldosterone level in the VSL#3(®) group, but no significant changes in the other measured parameters, including the stool microflora analysis. CONCLUSIONS Within the limitations of our sample size, VSL#3(®) therapy does not appear to have a significant impact on portal pressure reduction in patients with decompensated cirrhosis.
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Affiliation(s)
- Saumya Jayakumar
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Ohland CL, Kish L, Bell H, Thiesen A, Hotte N, Pankiv E, Madsen KL. Effects of Lactobacillus helveticus on murine behavior are dependent on diet and genotype and correlate with alterations in the gut microbiome. Psychoneuroendocrinology 2013; 38:1738-47. [PMID: 23566632 DOI: 10.1016/j.psyneuen.2013.02.008] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 02/08/2013] [Accepted: 02/08/2013] [Indexed: 12/19/2022]
Abstract
Modulation of the gut microbiota with diet and probiotic bacteria can restore intestinal homeostasis in inflammatory conditions and alter behavior via the gut-brain axis. The purpose of this study was to determine whether the modulatory effects of probiotics differ depending on diet and mouse genotype. At weaning, wild type (WT) and IL-10 deficient (IL-10(-/-)) 129/SvEv mice were placed on a standard mouse chow or a Western-style diet (fat 33%, refined carbohydrate 49%)±Lactobacillus helveticus ROO52 (10(9)cfu/d) for 21 days. Animal weight and food eaten were monitored weekly. Intestinal immune function was analysed for cytokine expression using the Meso Scale Discovery platform. Spatial memory and anxiety-like behavior was assessed in a Barnes maze. Terminal restriction fragment length polymorphism (TRFLP) was used to analyze the fecal microbiota. Both WT and IL-10(-/-) mice on a Western diet had increased weight gain along with changes in gut microbiota and cytokine expression and altered anxiety-like behavior. The ability of L. helveticus to modulate these factors was genotype- and diet-dependent. Anxiety-like behavior and memory were negatively affected by Western-style diet depending on inflammatory state, but this change was prevented with L. helveticus administration. However, probiotics alone decreased anxiety-like behavior in WT mice on a chow diet. Mice on the Western diet had decreased inflammation and fecal corticosterone, but these markers did not correlate with changes in behavior. Analysis of bacterial phyla from WT and IL-10(-/-)mice showed discrete clustering of the groups to be associated with both diet and probiotic supplementation, with the diet-induced shift normalized to some degree by L. helveticus. These findings suggest that the type of diet consumed by the host and the presence or absence of active inflammation may significantly alter the ability of probiotics to modulate host physiological function.
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Kish L, Hotte N, Kaplan GG, Vincent R, Tso R, Gänzle M, Rioux KP, Thiesen A, Barkema HW, Wine E, Madsen KL. Environmental particulate matter induces murine intestinal inflammatory responses and alters the gut microbiome. PLoS One 2013; 8:e62220. [PMID: 23638009 PMCID: PMC3634745 DOI: 10.1371/journal.pone.0062220] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 03/19/2013] [Indexed: 12/26/2022] Open
Abstract
Background Particulate matter (PM) is a key pollutant in ambient air that has been associated with negative health conditions in urban environments. The aim of this study was to examine the effects of orally administered PM on the gut microbiome and immune function under normal and inflammatory conditions. Methods Wild-type 129/SvEv mice were gavaged with Ottawa urban PM10 (EHC-93) for 7–14 days and mucosal gene expression analyzed using Ingenuity Pathways software. Intestinal permeability was measured by lactulose/mannitol excretion in urine. At sacrifice, segments of small and large intestine were cultured and cytokine secretion measured. Splenocytes were isolated and incubated with PM10 for measurement of proliferation. Long-term effects of exposure (35 days) on intestinal cytokine expression were measured in wild-type and IL-10 deficient (IL-10−/−) mice. Microbial composition of stool samples was assessed using terminal restriction fragment length polymorphism. Short chain fatty acids were measured in caecum. Results Short-term treatment of wild-type mice with PM10 altered immune gene expression, enhanced pro-inflammatory cytokine secretion in the small intestine, increased gut permeability, and induced hyporesponsiveness in splenocytes. Long-term treatment of wild-type and IL-10−/− mice increased pro-inflammatory cytokine expression in the colon and altered short chain fatty acid concentrations and microbial composition. IL-10−/− mice had increased disease as evidenced by enhanced histological damage. Conclusions Ingestion of airborne particulate matter alters the gut microbiome and induces acute and chronic inflammatory responses in the intestine.
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Affiliation(s)
- Lisa Kish
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Naomi Hotte
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Gilaad G. Kaplan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Renaud Vincent
- Environmental Health Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Robert Tso
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Michael Gänzle
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin P. Rioux
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aducio Thiesen
- Department of Lab Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Herman W. Barkema
- Department of Production Animal Health, University of Calgary, Calgary, Alberta, Canada
| | - Eytan Wine
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- * E-mail:
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Kish L, Hotte N, Kaplan GG, Vincent R, Tso R, Gänzle M, Rioux KP, Thiesen A, Barkema HW, Wine E, Madsen KL. Environmental particulate matter induces murine intestinal inflammatory responses and alters the gut microbiome. PLoS One 2013; 8:e62220. [PMID: 23638009 DOI: 10.1371/journal.pone.0062220.s003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 03/19/2013] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Particulate matter (PM) is a key pollutant in ambient air that has been associated with negative health conditions in urban environments. The aim of this study was to examine the effects of orally administered PM on the gut microbiome and immune function under normal and inflammatory conditions. METHODS Wild-type 129/SvEv mice were gavaged with Ottawa urban PM10 (EHC-93) for 7-14 days and mucosal gene expression analyzed using Ingenuity Pathways software. Intestinal permeability was measured by lactulose/mannitol excretion in urine. At sacrifice, segments of small and large intestine were cultured and cytokine secretion measured. Splenocytes were isolated and incubated with PM10 for measurement of proliferation. Long-term effects of exposure (35 days) on intestinal cytokine expression were measured in wild-type and IL-10 deficient (IL-10(-/-)) mice. Microbial composition of stool samples was assessed using terminal restriction fragment length polymorphism. Short chain fatty acids were measured in caecum. RESULTS Short-term treatment of wild-type mice with PM10 altered immune gene expression, enhanced pro-inflammatory cytokine secretion in the small intestine, increased gut permeability, and induced hyporesponsiveness in splenocytes. Long-term treatment of wild-type and IL-10(-/-) mice increased pro-inflammatory cytokine expression in the colon and altered short chain fatty acid concentrations and microbial composition. IL-10(-/-) mice had increased disease as evidenced by enhanced histological damage. CONCLUSIONS Ingestion of airborne particulate matter alters the gut microbiome and induces acute and chronic inflammatory responses in the intestine.
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Affiliation(s)
- Lisa Kish
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Looijer-van Langen M, Hotte N, Dieleman LA, Albert E, Mulder C, Madsen KL. Estrogen receptor-β signaling modulates epithelial barrier function. Am J Physiol Gastrointest Liver Physiol 2011; 300:G621-6. [PMID: 21252046 DOI: 10.1152/ajpgi.00274.2010] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Impaired epithelial barrier function and estrogens are recognized as factors influencing inflammatory bowel disease (IBD) pathology and disease course. Estrogen receptor-β (ERβ) is the most abundant estrogen receptor in the colon and a complete absence of ERβ expression is associated with disrupted tight-junction formation and abnormal colonic architecture. The aim of this study was to determine whether ERβ signaling has a role in the maintenance of epithelial permeability in the colon. ERβ mRNA levels and colonic permeability were assessed in IL-10-deficient mice and HLA-B27 rats by RT-PCR and Ussing chambers. ERβ expression and monolayer resistance were measured in HT-29 and T84 colonic epithelial monolayers by RT-PCR and electric cell-substrate impedance sensing. The effect of 17β-estradiol and an estrogen agonist [diarylpropionitrile (DPN)] and antagonist (ICI 182780) on epithelial resistance in T84 cells was measured. Expression of ERβ and proinflammatory cytokines was investigated in colonic biopsies from IBD patients. Levels of ERβ mRNA were decreased, whereas colonic permeability was increased, in IL-10-deficient mice and HLA-B27 transgenic rats prior to the onset of colitis. T84 cells demonstrated higher resistance and increased levels of ERβ mRNA compared with HT-29 cells. 17β-estradiol and DPN induced increased epithelial resistance in T84 cells, whereas an ERβ blocker prevented the increased resistance. Decreased ERβ mRNA levels were observed in colonic biopsies from IBD patients. This study suggests a potential role for ERβ signaling in the modulation of epithelial permeability and demonstrates reduced ERβ mRNA in animal models of colitis and colon of patients with inflammatory bowel disease.
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Sharma N, Hotte N, Rahman MH, Mohammadi M, Deyholos MK, Kav NNV. Towards identifying Brassica proteins involved in mediating resistance to Leptosphaeria maculans: a proteomics-based approach. Proteomics 2008; 8:3516-35. [PMID: 18668695 DOI: 10.1002/pmic.200701141] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To better understand the pathogen-stress response of Brassica species against the ubiquitous hemi-biotroph fungus Leptosphaeria maculans, we conducted a comparative proteomic analysis between blackleg-susceptible Brassica napus and blackleg-resistant Brassica carinata following pathogen inoculation. We examined temporal changes (6, 12, 24, 48 and 72 h) in protein profiles of both species subjected to pathogen-challenge using two-dimensional gel electrophoresis. A total of 64 proteins were found to be significantly affected by the pathogen in the two species, out of which 51 protein spots were identified using tandem mass spectrometry. The proteins identified included antioxidant enzymes, photosynthetic and metabolic enzymes, and those involved in protein processing and signaling. Specifically, we observed that in the tolerant B. carinata, enzymes involved in the detoxification of free radicals increased in response to the pathogen whereas no such increase was observed in the susceptible B. napus. The expression of genes encoding four selected proteins was validated using quantitative real-time PCR and an additional one by Western blotting. Our findings are discussed with respect to tolerance or susceptibility of these species to the pathogen.
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Affiliation(s)
- Nidhi Sharma
- Plant BioSystems & Agricultural Genomics and Proteomics Groups, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Hotte N. New method for prostate exam. CMAJ 1999; 160:1697. [PMID: 10410628 PMCID: PMC1230400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
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